Reorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UK
<p><strong>Background:</strong><br /> The coronavirus disease 2019 (COVID-19) pandemic has resulted in a rapid change in workload across healthcare systems. Factors related to this adaptation in UK primary care have not yet been examined.</p><br/> <p><st...
| Principais autores: | , , , , , , , , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado em: |
Royal College of General Practitioners
2020
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| _version_ | 1826275852753567744 |
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| author | Joy, M McGagh, D Jones, N Liyange, H Sherlock, J Parimalanathan, V Akinyemi, O van Vlymen, J Howsam, G Marshall, M Hobbs, FDR De Lusignan, S |
| author_facet | Joy, M McGagh, D Jones, N Liyange, H Sherlock, J Parimalanathan, V Akinyemi, O van Vlymen, J Howsam, G Marshall, M Hobbs, FDR De Lusignan, S |
| author_sort | Joy, M |
| collection | OXFORD |
| description | <p><strong>Background:</strong><br />
The coronavirus disease 2019 (COVID-19) pandemic has resulted in a rapid change in workload across healthcare systems. Factors related to this adaptation in UK primary care have not yet been examined.</p><br/>
<p><strong>Aim:</strong><br />
To assess the responsiveness and prioritisation of primary care consultation type for older adults during the COVID-19 pandemic.</p><br />
<p><strong>Design and Setting:</strong><br />
A cross-sectional database study examining consultations between 17 February and 10 May 2020 for patients aged ≥65 years, drawn from primary care practices within the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network, UK.</p><br />
<p><strong>Method:</strong><br />
The authors reported the proportion of consultation type across five categories: clinical administration, electronic/video, face-to-face, telephone, and home visits. Temporal trends in telephone and face-to-face consultations were analysed by polypharmacy, frailty status, and socioeconomic group using incidence rate ratios (IRR).</p><br />
<p><strong>Results:</strong><br />
Across 3 851 304 consultations, the population median age was 75 years (interquartile range [IQR] 70–82); and 46% (n = 82 926) of the cohort (N = 180 420) were male. The rate of telephone and electronic/video consultations more than doubled across the study period (106.0% and 102.8%, respectively). Face-to-face consultations fell by 64.6% and home visits by 62.6%. This predominantly occurred across week 11 (week commencing 9 March 2020), coinciding with national policy change. Polypharmacy and frailty were associated with a relative increase in consultations. The greatest relative increase was among people taking ≥10 medications compared with those taking none (face-to-face IRR 9.90, 95% CI = 9.55 to 10.26; telephone IRR 17.64, 95% CI = 16.89 to 18.41).</p><br />
<p><strong>Conclusion:</strong><br />
Primary care has undergone an unprecedented in-pandemic reorganisation while retaining focus on patients with increased complexity.</p> |
| first_indexed | 2024-03-06T23:05:07Z |
| format | Journal article |
| id | oxford-uuid:63825999-8bc5-4f5b-813d-1a0644fbc111 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:05:07Z |
| publishDate | 2020 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:63825999-8bc5-4f5b-813d-1a0644fbc1112022-03-26T18:13:32ZReorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UKJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:63825999-8bc5-4f5b-813d-1a0644fbc111EnglishSymplectic ElementsRoyal College of General Practitioners2020Joy, MMcGagh, DJones, NLiyange, HSherlock, JParimalanathan, VAkinyemi, Ovan Vlymen, JHowsam, GMarshall, MHobbs, FDRDe Lusignan, S<p><strong>Background:</strong><br /> The coronavirus disease 2019 (COVID-19) pandemic has resulted in a rapid change in workload across healthcare systems. Factors related to this adaptation in UK primary care have not yet been examined.</p><br/> <p><strong>Aim:</strong><br /> To assess the responsiveness and prioritisation of primary care consultation type for older adults during the COVID-19 pandemic.</p><br /> <p><strong>Design and Setting:</strong><br /> A cross-sectional database study examining consultations between 17 February and 10 May 2020 for patients aged ≥65 years, drawn from primary care practices within the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network, UK.</p><br /> <p><strong>Method:</strong><br /> The authors reported the proportion of consultation type across five categories: clinical administration, electronic/video, face-to-face, telephone, and home visits. Temporal trends in telephone and face-to-face consultations were analysed by polypharmacy, frailty status, and socioeconomic group using incidence rate ratios (IRR).</p><br /> <p><strong>Results:</strong><br /> Across 3 851 304 consultations, the population median age was 75 years (interquartile range [IQR] 70–82); and 46% (n = 82 926) of the cohort (N = 180 420) were male. The rate of telephone and electronic/video consultations more than doubled across the study period (106.0% and 102.8%, respectively). Face-to-face consultations fell by 64.6% and home visits by 62.6%. This predominantly occurred across week 11 (week commencing 9 March 2020), coinciding with national policy change. Polypharmacy and frailty were associated with a relative increase in consultations. The greatest relative increase was among people taking ≥10 medications compared with those taking none (face-to-face IRR 9.90, 95% CI = 9.55 to 10.26; telephone IRR 17.64, 95% CI = 16.89 to 18.41).</p><br /> <p><strong>Conclusion:</strong><br /> Primary care has undergone an unprecedented in-pandemic reorganisation while retaining focus on patients with increased complexity.</p> |
| spellingShingle | Joy, M McGagh, D Jones, N Liyange, H Sherlock, J Parimalanathan, V Akinyemi, O van Vlymen, J Howsam, G Marshall, M Hobbs, FDR De Lusignan, S Reorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UK |
| title | Reorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UK |
| title_full | Reorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UK |
| title_fullStr | Reorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UK |
| title_full_unstemmed | Reorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UK |
| title_short | Reorganisation of primary care for older adults during COVID-19: A cross-sectional database study in the UK |
| title_sort | reorganisation of primary care for older adults during covid 19 a cross sectional database study in the uk |
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