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新冠疫情对伊朗初级卫生保健系统中非传染性疾病预防与管理服务的影响

The Effect of the COVID-19 Pandemic on Non-Communicable Disease Prevention and Management Services in the Primary Health Care System of Iran.

作者信息

Afkar Mehdi, Rezanejad Asl Parisa, Mahdavi Hezaveh Alireza, Akrami Forouzan, Riazi-Isfahani Sahand, Peykari Niloofar, Payab Moloud, Moghisi Alireza, Yousefi Elham, Ranjbar Mansour, Soleymani Nejad Marzeyeh, Hamelmann Christoph, Slama Slim, Sadegh Tabrizi Jafar, Larijani Bagher, Raeisi Alireza, Ostovar Afshin

机构信息

Department of Community Medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

Network Management Center, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran.

出版信息

Med J Islam Repub Iran. 2022 Dec 26;36:174. doi: 10.47176/mjiri.36.174. eCollection 2022.

Abstract

The COVID-19 pandemic has caused significant disruptions in the provision of non-communicable disease (NCDs) prevention and control services in many countries, and there is a concern that it would lead to long-term complications of the diseases. The aim of this study is to assess the changes in the provisions of selected NCD services before and after the COVID-19 epidemic in Iran's primary healthcare system. In this descriptive-analytical retrospective study, the number of eight NCD services provided during the first 10 months of the COVID-19 pandemic from Feb 2020 to Dec 2020 were compared with the same period in the previous year using the data from the Iranian integrated electronic health record system (SIB) and also the association between the number of deaths due to COVID-19 and a sample of NCD services were assessed using cross-correlation analysis. The statistical analysis was performed in Stata Software v.14. The NCD services have decreased by an average of 18.89% compared to the same period in the previous year; this decline was much more severe at the beginning of the epidemic period (up to 75% in some services) and was greater in physician-provided services than in non-physician services. Also, examining the course of the selected services during this period, a gradual compensation was evident after the initial reduction. The general trend of the selected services of prevention and control of NCDs in the PHC system of Iran within 10 months after the onset of COVID-19 showed a sharp decline and subsequent gradual compensation. Although the process of compensation in some services may be considered somewhat reassuring, in the case of some essential services, more effort and attention to the implementation of programs or compensatory policies seem necessary.

摘要

新冠疫情在许多国家导致了非传染性疾病(NCDs)预防和控制服务的重大中断,人们担心这会导致这些疾病的长期并发症。本研究的目的是评估伊朗初级卫生保健系统在新冠疫情前后选定的非传染性疾病服务提供情况的变化。在这项描述性分析回顾性研究中,利用伊朗综合电子健康记录系统(SIB)的数据,将2020年2月至2020年12月新冠疫情头10个月期间提供的八项非传染性疾病服务数量与上一年同期进行了比较,并使用交叉相关分析评估了新冠死亡人数与部分非传染性疾病服务之间的关联。统计分析在Stata软件v.14中进行。与上一年同期相比,非传染性疾病服务平均减少了18.89%;在疫情初期,这种下降更为严重(某些服务高达75%),医生提供的服务下降幅度大于非医生提供的服务。此外,研究这一时期选定服务的过程,在最初减少之后,明显出现了逐渐的补偿。新冠疫情爆发后10个月内,伊朗初级卫生保健系统中选定的非传染性疾病预防和控制服务的总体趋势显示出急剧下降,随后逐渐补偿。虽然某些服务的补偿过程可能在一定程度上令人安心,但对于某些基本服务而言,似乎有必要付出更多努力并关注项目或补偿政策的实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c6/9997416/f44db13e43ea/mjiri-36-174-g001.jpg

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