Redesigning Primary Care to Address the COVID-19 Pandemic in the Midst of the Pandemic

Krist, Alex H.; DeVoe, Jennifer E.; Cheng, Anthony; Ehrlich, Thomas; Jones, Stanley E.

doi:10.1370/afm.2557

Cited by 175 publications

(214 citation statements)

References 14 publications

(10 reference statements)

Supporting

Mentioning

173

Contrasting

Unclassified

Order By: Relevance

“…Several countries prepared for a global viral/infectious outbreak because of the 2009 H1N1 pandemic (Kotalik, 2005 ). However, the rapid spreading of the COVID-19 pandemic and many deaths worldwide show the greater danger of this disease concerning other health crises (Krist et al, 2020 ). Indeed, the COVID-19 pandemic also has a negative effect on stakeholders’ needs satisfaction (β 1d = − 0.204; p -value < 0.10), supporting H1d.…”

Section: Resultsmentioning

confidence: 99%

Digital social entrepreneurship: the N-Helix response to stakeholders’ COVID-19 needs

et al. 2021

View full text Add to dashboard Cite

This study explores the emergence of a new entrepreneurship phenomenon (digital social entrepreneurship) as a result of the collaboration among many agents (N-Helix), given the government’s limited capacity to respond to the stakeholders’ needs satisfaction related to an exogenous event (e.g., the COVID-19 pandemic). Our theory development is based on three ongoing academic debates related to (a) the unrepresentativeness of the stakeholder theory in entrepreneurship research; (b) the emergence of digital social entrepreneurship (DSE) as a bridge between stakeholders’ needs, socio-economic actors, and digital-social initiatives; and (c) the role of N-Helix collaborations to facilitate the emergence of global knowledge-intensive initiatives and the rapid adoptions of open innovations. Our results support our assumptions about the positive mediation effect of DSE in the relationship between N-Helix collaborations and stakeholders’ satisfaction. Notably, results show how pandemic has intensified these relationships and how DSE in N-Helix collaborations can generate social impacts globally. Some implications for policy-makers have emerged from our results that should be considered during/post-COVID-19 pandemic.

show abstract

Section: Resultsmentioning

confidence: 99%

Digital social entrepreneurship: the N-Helix response to stakeholders’ COVID-19 needs

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The COVID-19 pandemic has brought dramatic changes in the delivery of primary health care, especially for patients with respiratory tract infections [ 1 , 2 ]. The pandemic prompted an unprecedented restructuring of primary care practice, resulting in a rapid switch from face-to-face to remote consultations.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study

et al. 2021

View full text Add to dashboard Cite

In 2020, the COVID-19 pandemic brought dramatic changes in the delivery of primary health care across the world, presumably changing the number of consultations for infectious diseases and antibiotic use. We aimed to assess the impact of the pandemic on infections and antibiotic prescribing in Dutch primary care. All patients included in the routine health care database of the Julius General Practitioners’ Network were followed from March through May 2019 (n = 389,708) and March through May 2020 (n = 405,688). We extracted data on consultations for respiratory/ear, urinary tract, gastrointestinal and skin infections using the International Classification of Primary Care (ICPC) codes. These consultations were combined in disease episodes and linked to antibiotic prescriptions. The numbers of infectious disease episodes (total and those treated with antibiotics), complications, and antibiotic prescription rates (i.e., proportion of episodes treated with antibiotics) were calculated and compared between the study periods in 2019 and 2020. Fewer episodes were observed during the pandemic months than in the same months in 2019 for both the four infectious disease entities and complications such as pneumonia, mastoiditis and pyelonephritis. The largest decline was seen for gastrointestinal infections (relative risk (RR), 0.54; confidence interval (CI), 0.51 to 0.58) and skin infections (RR, 0.71; CI, 0.67 to 0.75). The number of episodes treated with antibiotics declined as well, with the largest decrease seen for respiratory/ear infections (RR, 0.54; CI, 0.52 to 0.58). The antibiotic prescription rate for respiratory/ear infections declined from 21% to 13% (difference −8.0% (CI, −8.8 to −7.2)), yet the prescription rates for other infectious disease entities remained similar or increased slightly. The decreases in primary care infectious disease episodes and antibiotic use were most pronounced in weeks 15–19, mid-COVID-19 wave, after an initial peak in respiratory/ear infection presentation in week 11, the first week of lock-down. In conclusion, our findings indicate that the COVID-19 pandemic has had profound effects on the presentation of infectious disease episodes and antibiotic use in primary care in the Netherlands. Consequently, the number of infectious disease episodes treated with antibiotics decreased. We found no evidence of an increase in complications.

show abstract

“…Although the burden of managing the COVID-19 pandemic initially fell on hospitals, this situation has gradually changed; primary care services are handling more cases, which is requiring substantial changes in the way primary care services are delivered to populations to manage the COVID-19 pandemic [22]. Patients are usually encouraged to request advice and speak first to a primary care physician by telephone or a video call to avoid in-person appointments and going to primary care settings.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Mayer¹,

Vidal-Alaball²,

Puigdellı́vol-Sánchez³

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

Background The country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic. Objective The objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19. Methods An observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain. Results The study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17% of the patients were aged ≥60 years. 175,484/348,596 patients (50.34%) were women. A total of 23,844/348,596 patients (6.84%) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1%) and obesity (5181 patients, 21.7%). Overall, 2680/348,596 patients in the study population (0.77%) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56%; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58%; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95% CI 6.06-7.15). Conclusions We observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2.

show abstract

Redesigning Primary Care to Address the COVID-19 Pandemic in the Midst of the Pandemic

Cited by 175 publications

References 14 publications

Digital social entrepreneurship: the N-Helix response to stakeholders’ COVID-19 needs

Digital social entrepreneurship: the N-Helix response to stakeholders’ COVID-19 needs

Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Contact Info

Product

Resources

About