Annals of family medicine
-
Annals of family medicine · Jan 2021
A Tale of 3 Asian Cities: How is Primary Care Responding to COVID-19 in Hong Kong, Singapore, and Beijing.
Hong Kong, Singapore, and Beijing have some of the highest numbers of international arrivals and densest living spaces globally, yet these cities have reported low numbers of deaths amid the coronavirus disease 2019 (COVID-19) outbreak. Primary care has played different roles in each of the health systems in combatting the pandemic. Both Hong Kong and Singapore have a 2-tiered health system with the majority of primary care provided in the private sector. ⋯ Beijing's unique response has consisted of using online platforms for general practitioners to facilitate monitoring among community residents, as well as public health education and a mobilized pharmacy refill program to reduce risk of transmission. Established challenges, however, include shortages of personal protective equipment and the heavy workload for health care staff. Regardless, all 3 cities have demonstrated enhanced preparedness since experiencing the severe acute respiratory syndrome epidemic, and the responses of their primary care systems therefore may offer learning points for other countries during the COVID-19 pandemic.
-
Annals of family medicine · Jan 2021
The COVID-19 Pandemic in Nijmegen, the Netherlands: Changes in Presented Health Problems and Demand for Primary Care.
We studied the changes in presented health problems and demand for primary care since the outbreak of coronavirus disease 2019 (COVID-19) in the Netherlands. We analyzed prominent symptom features of COVID-19, and COVID-19 itself as the reason for encounter. ⋯ We observed a dramatic increase of telephone/e-mail/Internet consultations in the months after the outbreak. Contacts for other health problems such as prevention and acute and chronic conditions plummeted substantially (P <0.001); mental health problems stabilized.
-
Annals of family medicine · Jan 2021
Observational StudyDiagnostic Agreement Between Telemedicine on Social Networks and Teledermatology Centers.
With increasing delays in obtaining a dermatological consultation, general practitioners (GPs) are using social networks for telemedicine to obtain advice on dermatological images. The objective was to analyze diagnostic agreement between telemedicine on social networks (Twitter and MedPics) and standard teledermatology services (TDS). ⋯ Diagnostic agreement using social network images showed that use of this telemedicine tool could be a reliable means to alleviate the difficulties of accessing dermatology consultations although data safety probably needs to be improved.
-
Annals of family medicine · Jan 2021
Cherry Blossoms, COVID-19, and the Opportunity for a Healthy Life.
To date, short-term funding and policy fixes for the coronavirus disease 2019 (COVID-19) pandemic have focused on saving the current health care system; policies have not maximized the population's health, prioritized the safety net, nor addressed the fundamental problems that have hindered our nation's response for our most vulnerable neighbors. We need to plan more lasting equity-specific reforms now. I explain 3 lessons that should inform reforms to the health care delivery and payment systems to reduce health disparities and maximize the public's health: (1) Proven roadmaps and processes for reducing health care disparities already exist, as do themes of successful interventions. Implement them; (2) Payment reform needs to create a business case for health care organizations to address social determinants of health and implement care interventions to reduce health disparities; (3) We as a nation need to have hard conversations about whether we truly value the opportunity for everyone to have a healthy life.
-
Annals of family medicine · Jan 2021
Decreasing Use of Primary Care: A Repeated Cross-Sectional Study of MEPS 2007-2017.
We sought to describe the proportion of patients in contact with a primary care physician, as well as the total number of primary care contacts over a 2-year period, using the 2002-2017 Medical Expenditure Panel Survey. The rate of any contact with a primary care physician for patients in the population decreased by 2.5% over the study period (adjusted odds ratio [aOR] = 0.99 per panel, 95% CI, 0.98-0.99; P <.001). ⋯ The decreases were observed across all age groups at varying rates. The results of this study suggest that the driver for the previously reported decreases in primary care visits is secondary to fewer contacts per patient.