Inhalt des Dokuments
Relationship between the perceived strength of countries’ primary care system and COVID-19 mortality: an international survey study.
Autoren | Goodyear-Smith F,
Kinder K, Mannie C, Strydom S, Bazemore A, Phillips Jr
RL |
Journal | BJGP
Open, DOI:10.3399/bjgpopen20X101129 |
Abstract
Background: Strong primary health
care (PHC) is the cornerstone for universal health coverage and a
country’s health emergency response. PHC includes public health
and first- contact primary care (PC).
Internationally, the
spread of COVID-19 and mortality rates vary widely. The authors
hypothesised that
countries perceived to have strong PHC have
lower COVID-19 mortality rates.
Aim: To compare perceptions of PC
experts on PC system strength, pandemic preparedness, and
response with COVID-19 mortality rates in countries globally.
Design & setting: A convenience sample of international PHC
experts (clinicians, researchers, and
policymakers) completed an
online survey (in English or Spanish) on country- level PC attributes
and
pandemic responses.
Method: Analyses of perceived PC strength,
pandemic plan use, border controls, movement restriction,
and
testing against COVID-19 mortality were undertaken for 38 countries
with ≥5 responses.
Results: In total, 1035 responses were
received from 111 countries, with 1 to 163 responders per
country. The 38 countries with ≥5 responses were included in the
analyses. All world regions and
economic tiers
were represented. No correlation was
found between PC strength and mortality.
Country- level mortality negatively
correlated with perceived stringent
border control, movement
restriction, and testing
regimes.
Conclusion: Countries perceived by expert
participants as having a prepared pandemic plan and a
strong PC
system did not necessarily experience lower COVID-19 mortality rates.
What appears to
make a difference to containment is if and when
the plan is implemented, and how PHC is mobilised
to respond.
Many factors contribute to spread and outcomes. Important responses
are first to limit
COVID-19 entry across borders, then to
mobilise PHC, integrating the public health and PC sectors
to mitigate spread and reduce
burden on hospitals through hygiene,
physical distancing, testing,
triaging, and
contract- tracing measures.