Primary health care organization in the Covid-19 pandemic: scoping review

ABSTRACT OBJECTIVE Mapping available scientific evidence on the organization of primary health care services and professionals during the Covid-19 pandemic. METHODS This is a scoping review that followed the Joanna Briggs Institute method. Articles published in Portuguese, Spanish, and English from January 2020 to January 2021 in the CINAHL, Lilacs, Medline, PubMed, and Web of Science databases were included. RESULTS We selected 24 articles that presented the reorganization of primary health care services and professionals to care suspected or confirmed Covid-19 cases. Coordination measures to tackle this disease in primary health care help to control its infection, especially by the active search for respiratory symptoms, the detection of new cases, and the monitoring of confirmed cases. CONCLUSION This study presents an overview of how primary health care services and professionals organized themselves to tackle the Covid-19 pandemic, addressing adjustments in infrastructure and care flows, such as establishing specific Covid-19 care units, separating infected and non-infected patients, using telemedicine as an alternative modality of care, and monitoring cases by applications and phone.

【摘要】
目的：梳理新冠（COVID-19）疫情期间初级卫生保健（primary health care）服务与从业人员的组织模式相关现有科学证据。
方法：本研究为遵循乔安娜·布里格斯研究所（Joanna Briggs Institute）方法的范围综述（scoping review）。纳入2020年1月至2021年1月期间，以葡萄牙语、西班牙语及英语发表于CINAHL、Lilacs、Medline、PubMed与Web of Science数据库的相关文献。
结果：最终筛选出24篇文献，均围绕初级卫生保健服务与从业人员为疑似或确诊新冠病例提供照护所开展的重组工作展开。在初级卫生保健体系中，针对该疾病的协调防控举措有助于控制病毒传播，尤其体现在主动开展呼吸道症状排查、识别新增病例以及对确诊病例开展随访监测等方面。
结论：本研究概述了初级卫生保健服务与从业人员为应对新冠疫情所采取的组织策略，涵盖基础设施与诊疗流程的多项调整，例如设立专属新冠诊疗单元、区分感染与非感染患者、将远程医疗（telemedicine）作为替代诊疗模式，以及通过应用程序与电话开展病例监测工作。