Intensieve en palliatieve covid-19-zorg door huisarts

Translated title of the contribution: Intensive covid-19 care in general practice; nationwide registration study, initiated by General Practice Research Consortium Netherlands

J W L Cals, R Derckx, M H Blanker

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

METHOD: Registration system initiated by General Practice Research Consortium Netherlands (GPRC-NL).

AIM: To obtain national estimates on clinically suspected Covid-19 mortality in general practice and on intensive and palliative covid-19 care provided by general practitioners (GPs) outside hospital, including palliative medication, availability of personal protective equipment, and reasons for not referring to hospital of vulnerable patients during the first three months of the Covid-19 pandemic in The Netherlands.

DESIGN: Nationwide registration study, in which 2.331 GP practices in The Netherlands participated from March-June 2020.

METHOD: Registration system initiated by General Practice Research Consortium Netherlands (GPRC-NL) through existing digital referral platform ZorgDomein, in which GPs could report PCR-proven and clinically suspected Covid-19 deceased patients to estimate the impact of the Covid-19 pandemic in primary care.

RESULTS: GPs reported 1,566 Covid-19 deceased patients, of which 61% (949/1,566) were clinically suspected but not PCR-tested, with large regional differences, and most deaths being reported in the provinces of Brabant and Limburg. Patients had a median duration from onset of symptoms to death of 8 days and a median age of 87 years. GPs reported 1,030 patients for which they delivered intensive or palliative care, of which 56% had a Clinical Frailty Score higher or equal to six. Most mentioned reason for GPs and patients in the decision not going to hospital were the explicit wish of the patient (59%) and somatic vulnerability (52%).

CONCLUSION: GPs provided palliative care to a large number of clinically suspected Covid-19 vulnerable patients with large regional differences across The Netherlands. Reported GPs' and patients' considerations to refrain from hospital care can be used to guide future primary care for vulnerable Covid-19 patients.

Translated title of the contributionIntensive covid-19 care in general practice; nationwide registration study, initiated by General Practice Research Consortium Netherlands
Original languageDutch
Article numberD5616
Number of pages9
JournalNederlands Tijdschrift voor Geneeskunde
Volume164
Publication statusPublished - 4 Jan 2021

Keywords

  • Aged, 80 and over
  • Ambulatory Care/statistics & numerical data
  • COVID-19/diagnosis
  • COVID-19 Nucleic Acid Testing/statistics & numerical data
  • Clinical Decision-Making
  • Critical Care/methods
  • Female
  • General Practice/methods
  • Humans
  • Male
  • Netherlands/epidemiology
  • Palliative Care/methods
  • Patient Preference
  • Referral and Consultation/statistics & numerical data
  • Registries/statistics & numerical data
  • SARS-CoV-2/isolation & purification

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