Promjena strukture rada timova obiteljske medicine u zapadnom dijelu Zagreba zbog COVID-19 pandemije

professional thesis

• Title (english): The practice management change in family practice teams in the western part of Zagreb due to the COVID-19 pandemic
• Author: Juraj Jug
• Mentor: Miroslav Hanževački (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2022-05-07, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Family Medicine

Abstract

Uvod: COVID-19 pandemija promijenila je naš svakodnevni život što je utjecalo i na rad timova obiteljske medicine. Grad Zagreb obilježavaju velike varijacije broja osiguranika po timu obiteljske medicine ovisno o gradskoj četvrti čime je kvalitetno pružanje zdravstvene skrbi u pojedinim dijelovima grada dovedeno u pitanje.

Cilj: Utvrditi postoji li promjena u strukturi rada timova obiteljske medicine tijekom pet radnih dana u tjednu ovisno o radnoj smjeni u administrativnom poslu, pregledima, konzultacijama i ostalim postupcima tijekom COVID-19 pandemije u odnosu na 2019. godinu.

Metode: Radi se o presječnom istraživanju u kojem su putem mjesečnih izvješća za ožujak i travanj 2019. i 2021. godine u 65 ordinacija obiteljske medicine (45 domskih i 21 privatnih) zapada grada Zagreba analizirani svi obavljeni dijagnostičko-terapijski postupci podijeljeni u četiri glavne kategorije (administracija, telefonske i e-mail konzultacije, pregledi i konzultacije uživo te ostali dijagnostički postupci u ordinaciji) prema smjeni u radnom danu u tjednu te kvartu kojem ordinacija pripada.

Rezultati: U ispitivanom razdoblju došlo je do smanjenja administrativnog posla za 5,43 % i fizičkih kontakata i pregleda u ordinaciji za 29,17 % te povećanja telefonskih i e-mail konzultacija za 114,98 % kao i ukupnog broja osiguranika koji su koristili zdravstvenu skrb ordinacije obiteljske medicine za 8,38 %. Opseg ukupnog posla timova obiteljske medicine, od čega se 25 % ukupnog tjednog posla obavljalo ponedjeljkom, ovisio je o četvrti grada Zagreba, a povećan je u 2021. godini za 10,68 % u odnosu na 2019. godinu. Udio fizičkih pregleda u broju svih konzultacija s ordinacijom u pandemiji značajno je manji za 29 - 58 % ovisno o gradskoj četvrti. Tri četvrtine timova obiteljske medicine u pandemiji obavljalo je kućne posjete (medijan 2,5 posjeta mjesečno), a 61,53 % radilo je EKG (medijan 7 u domskim vs. 20 EKG zapisa u privatnim ordinacijama mjesečno; p < 0,01).

Zaključak: Struktura rada timova ordinacija obiteljske medicine značajno se promijenila u COVID-19 pandemiji što je najizraženije u udvostručenju učinjenih telefonskih i e-mail konzultacija te padu pregleda bolesnika u ordinaciji za trećinu. Struktura rada ovisila je također o lokaciji ordinacije u gradu Zagrebu te smjeni u radnom danu u tjednu.

Abstract (english)

Introduction: COVID-19 pandemic has changed our everyday life and impacted the family medicine practice workload. The number of patients per one family medicine practice in Zagreb significantly varies with its location which can limit the quality of healthcare in particular parts of the city.

Aim: To determine whether there are changes in the family medicine practice management during five working days of the week depending on the work shift in administrative work, check-ups, consultations, and other diagnostic procedures during the COVID-19 pandemic compared to 2019.

Methods: In this cross-sectional study 65 family medicine practices from the western part of Zagreb (45 from Health centre Zagreb - West and 21 private practices) were analysed by monthly work reports for March and April of 2019 and 2021. All noted diagnostic-therapeutic procedures are divided into four main groups (administration, telephone, and e-mail consultations, check-ups and live consultations, and other diagnostic procedures) and analysed depending on the day of the week, shift, and neighbourhood.

Results: The amount of administrative work as well as the number of check-ups and live consultations dropped by 5.43 % and 29.17 % respectively, whereas the number of telephone and e-mail consultations increased by 114.98 %, just as the total number of patients increased per day by 8.38 % in the analysed period. The amount of total work done by an average family medicine team depended on the location, 25 % of it was done on Monday and was increased by 10.68 % in 2021 compared with 2019. The ratio of live check-ups in the number of all consultations was decreased by 29 to 58 % depending on the neighbourhood where the practice was located. Three-quarters of family medicine teams did home visits (median 2.5 visits monthly), and 61.53 % of all analysed teams performed ECG (median 7 in practices in Health centre vs. 20 ECGs in private practices per month, p < 0.01).

Conclusion: The family medicine practice management was significantly changed in the COVID-19 pandemic which was demonstrated by a double number of telephone and e-mail consultations whereas the number of live check-ups was decreased by one-third. Workload also depended on the family medicine practice location in Zagreb, working shift, and the day of the week.

• Keywords: COVID 19; obiteljska medicina; struktura rada; opterećenje radom
• Keywords (english): COVID 19; family practice; practice management; workload
• Language: croatian
• URN:NBN: urn:nbn:hr:105:007901
• Study programme: Title: Family Medicine; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra obiteljske medicine (sveučilišni/a magistar/magistra obiteljske medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-04-05 11:23:17