The effect of the COVID-19 pandemic on primary care physicians in Israel, with comparison to an international cohort: a cross-sectional study
Tóm tắt
The COVID-19 pandemic had a major impact on primary care and primary care physicians (PCPs) in Israel and around the world. There is paucity of information regarding treatment of patients with COVID-19 in the community, since most research was performed in hospitals. The aim of this study was to describe the Israeli PCPs’ experience.
This study is a part of an international cross-sectional study, the PRICOV-19. A translated version of the questionnaire was distributed among Israeli PCPs from December 2020 to July 2021. In this study, we describe the Israeli results and compare them to the international results. 5,961 respondents from 29 countries answered the questionnaire, 94 from Israel, with an Israeli response rate of 16%. Israeli PCPs reported an increase in use of telemedicine from 11 to 49% during the COVID epidemic. PCPs also reported a decline in their wellbeing; absence of secured time slots for keeping updated; perception that the Ministry of Health guidelines were a threat to the staff wellbeing and organization of practice and delays in the examination of non-COVID urgent cases. The findings of this study raise concerns regarding the PCPs experience and may form the basis for an improved process of care. Guidelines for proper usage of telemedicine, substitutes for the physical examination and procedures for minimizing delayed patient examination for urgent conditions should be developed. Government directives and clinical guidelines should be communicated in a timely manner, with secured timeslots for physicians’ self-learning or updating. Ensuring physicians’ well-being in general should be an organization priority.
Tài liệu tham khảo
IsraeliState Comptroller: community medicine during covid-19 pandemic - Interimfindings for 2021 annual report. [cited 2021 Aug 25]. 2021; Available from: https://www.mevaker.gov.il/sites/DigitalLibrary/Pages/Reports/3856-6.aspx?AspxAutoDetectCookieSupport=1
Shapiro Ben David S, Cohen D, Karplus R, Irony A, Ofer-Bialer G, Potasman I, et al. COVID-19 community care in Israel-a nationwide cohort study from a large health maintenance organization. J Public Health; 2021
Liaw S-T, Kuziemsky C, Schreiber R, Jonnagaddala J, Liyanage H, Chittalia A, et al. Primary care informatics response to covid-19 pandemic: adaptation, progress, and lessons from four countries with high ICT development. Yearb Med Inform. 2021;30(1):44–55.
Matenge S, Sturgiss E, Desborough J, Hall Dykgraaf S, Dut G, Kidd M. Ensuring the continuation of routine primary care during the COVID-19 pandemic: a review of the international literature. Fam Pract. 2021;
Murphy M, Scott LJ, Salisbury C, Turner A, Scott A, Denholm R, et al. Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study. Br J Gen Pract. 2021;71(704):e166–77.
de Sutter A, Llor C, Maier M, Mallen C, Tatsioni A, van Weert H, et al. Family medicine in times of “COVID-19”: a generalists’ voice. Eur J Gen Pract. 2020;26(1):58–60.
Verhoeven V, Tsakitzidis G, Philips H, Van Royen P. Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs. BMJ Open. 2020;10(6):e039674.
Windak A, Frese T, Hummers E, Klemenc Ketis Z, Tsukagoshi S, Vilaseca J, et al. Academic general practice/family medicine in times of COVID-19 - Perspective of WONCA Europe. Eur J Gen Pract. 2020;26(1):182–8.
Pearman A, Hughes ML, Smith EL, Neupert SD. Mental health challenges of united states healthcare professionals during COVID-19. Front Psychol. 2020;13(11):2065.
Mosheva M, Hertz-Palmor N, Dorman Ilan S, Matalon N, Pessach IM, Afek A, et al. Anxiety, pandemic-related stress and resilience among physicians during the COVID-19 pandemic. Depress Anxiety. 2020;37(10):965–71.
Denning M, Goh ET, Tan B, Kanneganti A, Almonte M, Scott A, et al. Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: a multinational cross-sectional study. PLoS ONE. 2021;16(4):e0238666.
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976.
Sung C-W, Chen C-H, Fan C-Y, Chang J-H, Hung CC, Fu C-M, et al. Mental health crisis in healthcare providers in the COVID-19 pandemic: a cross-sectional facility-based survey. BMJ Open. 2021;11(7):e052184.
Van Poel E, Vanden Bussche P, Klemenc-Ketis Z, Willems S. How did general practices organize care during the COVID-19 pandemic: the protocol of the cross-sectional PRICOV-19 study in 38 countries. BMC Prim Care. 2022;23(1):11.
Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208.
Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Utility of a brief screening tool to identify physicians in distress. J Gen Intern Med. 2013;28(3):421–7.
Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Ability of the physician well-being index to identify residents in distress. J Grad Med Educ. 2014;6(1):78–84.
Dyrbye LN, Satele D, Shanafelt T. Ability of a 9-item well-being index to identify distress and stratify quality of life in US workers. J Occup Environ Med. 2016;58(8):810–7.
Sharma SC, Sharma S, Thakker A, Sharma G, Roshan M, Varakantam V. Revolution in UK general practice due to COVID-19 pandemic: a cross-sectional survey. Cureus. 2020;12(8):e9573.
Gomez T, Anaya YB, Shih KJ, Tarn DM. A qualitative study of primary care physicians’ experiences with telemedicine during COVID-19. J Am Board Fam Med. 2021;34(Suppl):S61–70.
Jabbarpour Y, Jetty A, Westfall M, Westfall J. Not telehealth: which primary care visits need in-person care? J Am Board Fam Med. 2021;34(Suppl):S162–9.
Due TD, Thorsen T, Andersen JH. Use of alternative consultation forms in Danish general practice in the initial phase of the COVID-19 pandemic–a qualitative study. BMC Fam Pract. 2021;22(1):108.
Turner A, Scott A, Horwood J, Salisbury C, Denholm R, Scott L, et al. Maintaining face-to-face contact during the COVID-19 pandemic: a longitudinal qualitative investigation in UK primary care. Br J Gen Pract Open. 2021
Stephenson E, O’Neill B, Gronsbell J, Butt DA, Crampton N, Ji C, et al. Changes in family medicine visits across sociodemographic groups after the onset of the COVID-19 pandemic in Ontario: a retrospective cohort study. CMAJ Open. 2021;9(2):E651–8.
Masroor S. Collateral damage of COVID-19 pandemic: delayed medical care. J Card Surg. 2020;35(6):1345–7.
Fournier J-P, Amélineau J-B, Hild S, Nguyen-Soenen J, Daviot A, Simonneau B, et al. Patient-safety incidents during COVID-19 health crisis in France: an exploratory sequential multi-method study in primary care. Eur J Gen Pract. 2021;27(1):142–51.
Helsper CW, Campbell C, Emery J, Neal RD, Li L, Rubin G, et al. Cancer has not gone away: a primary care perspective to support a balanced approach for timely cancer diagnosis during COVID-19. Eur J Cancer Care Engl. 2020;29(5):e13290.
Laing S, Johnston S. Estimated impact of COVID-19 on preventive care service delivery: an observational cohort study. BMC Health Serv Res. 2021;21(1):1107.
Kiss P, Carcel C, Hockham C, Peters SAE. The impact of the COVID-19 pandemic on the care and management of patients with acute cardiovascular disease: a systematic review. Eur Heart J Qual Care Clin Outcomes. 2021;7(1):18–27.
Baptista S, Teixeira A, Castro L, Cunha M, Serrão C, Rodrigues A, et al. Physician burnout in primary care during the covid-19 pandemic: a cross-sectional study in Portugal. J Prim Care Community Health. 2021;12:21501327211008436.
Ofei-Dodoo S, Loo-Gross C, Kellerman R. Burnout, depression, anxiety, and stress among family physicians in kansas responding to the COVID-19 pandemic. J Am Board Fam Med. 2021;34(3):522–30.
Martin M. Physician well-being: physician burnout. FP Essent. 2018;471:11–5.
Le Floch B, Bastiaens H, Le Reste JY, Lingner H, Hoffman R, Czachowski S, et al. Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network. BMC Fam Pract. 2019;20(1):96.
Family Physicians in Israel. https://www.health.gov.il/PublicationsFiles/FamilyHealth_2018.pdf.Accessed 14 August 2022; 2018