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Special Issue "Primary Health Care: Challenges and Recommendations during a Pandemic"

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: 31 October 2023 | Viewed by 6200

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Special Issue Editor

Dr. Pierpaolo Ferrante

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Guest Editor

Occupational Medicine Department (DML), National Workers Compensation Authority (INAIL), Research Area, Via Stefano Gradi 55, 00143 Rome, Italy
Interests: epidemiology; public health; statistical methods

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has dramatically confronted the world with a worrying global fragility: we are not prepared enough to manage pandemics. To improve the global response to the current and future threats, national pandemic plans should be integrated into a comprehensive strategy and driven by a multidisciplinary approach. Furthermore, they should be flexible enough to be updated according to the latest available data, collected through effective, homogeneous, and connected epidemiological surveillance systems. A primary goal they must pursue is to protect the health care workers and to avoid the health system saturation. In such modern and effective pandemic plans, primary health care (PHC) plays the key role in the frontline of the whole response system and carries out multiple tasks including:

To provide early diagnoses (to contain the virus spread) even through video consultations where feasible;
To manage mild cases mitigating pressure on the hospitals;
To be involved in activities of contact tracing, in the epidemiological surveillance system, and in the vaccination campaigns;
To provide up-to-date information to population about the disease and the related prevention measures;
To assure continuity of treatments to patients with chronic conditions;
To learn by daily experience.

What COVID-19 pandemic taught us is that the stronger the PHC is, the more resilient the health system. A successful pandemic plan must rely on a solid PHC.

Research problem considered in this Special Issue:

Sharing the successes and failures PHC has experienced around the world could help health institutions to better prepare for the future. This thematic Special Issue aims to collect the acquired pandemic experience by health professionals in all fields of the PHC. We encourage (without limiting to) submissions of papers about:

The impact of COVID-19 on the national PHC highlighting the stress points (burnout and stress among workers; structural and infrastructural lacks; disruption and delays in out-patient visits: obstetric care, chronic diseases and palliative care; discomforts of nurses working outside of hospitals; etc.) to be strengthened;
The adopted protocols and polices involving the PHC (awareness campaign; PHC as triage; role of PHC in Surveillance; role of PHC in vaccine campaigns; integration of PHC and Public Health; etc.) ;
The innovative experiences (new models in primary care; measures of service quality; telehealth; hospital at home; virtual hospital; etc.) that may drive the PHC evolution.

By sharing your valuable contribution with us, you will help to raise awareness of the central role of PHC in future Health Systems.

Dr. Pierpaolo Ferrante
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

primary health care
pandemics
COVID-19
Healthcare resilience
burnout
out-patient visits
triage
obstetric care
chronic diseases
palliative care
prevention measures
epidemiological Surveillance
awareness campaign
vaccine campaign
integrated Public Health system
video consultations
telehealth
hospital at home
virtual hospital
primary care models
measures of service quality

Published Papers (5 papers)

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Research

Open AccessArticle

Personnel Scheduling during the COVID-19 Pandemic: A Probabilistic Graph-Based Approach

and

Healthcare 2023, 11(13), 1917; https://doi.org/10.3390/healthcare11131917 - 03 Jul 2023

Viewed by 542

Abstract

Effective personnel scheduling is crucial for organizations to match workload demands. However, staff scheduling is sometimes affected by unexpected events, such as the COVID-19 pandemic, that disrupt regular operations. Limiting the number of on-site staff in the workplace together with regular testing is an effective strategy to minimize the spread of infectious diseases like COVID-19 because they spread mostly through close contact with people. Therefore, choosing the best scheduling and testing plan that satisfies the goals of the organization and prevents the virus’s spread is essential during disease outbreaks. In this paper, we formulate these challenges in the framework of two Mixed Integer Non-linear Programming (MINLP) models. The first model aims to derive optimal staff occupancy and testing strategies to minimize the risk of infection among employees, while the second is aimed only at optimal staff occupancy under a random testing strategy. To solve the problems expressed in the models, we propose a canonical genetic algorithm as well as two commercial solvers. Using both real and synthetic contact networks of employees, our results show that following the recommended occupancy and testing strategy reduces the risk of infection 25–60% under different scenarios. The minimum risk of infection can be achieved when the employees follow a planned testing strategy. Further, vaccination status and interaction rate of employees are important factors in developing scheduling strategies that minimize the risk of infection. Full article

(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)

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Open AccessArticle

Challenges in Caring for People with Cardiovascular Disease through and beyond the COVID-19 Pandemic: The Advantages of Universal Access to Home Telemonitoring

Luminita Iliuță

Andreea Gabriella Andronesi

Marius Rac-Albu

Florentina Ligia Furtunescu

Mădălina-Elena Rac-Albu

Alexandru Scafa-Udriște

Horațiu Moldovan

and

Eugenia Panaitescu

Healthcare 2023, 11(12), 1727; https://doi.org/10.3390/healthcare11121727 - 12 Jun 2023

Viewed by 720

Abstract

(1) Background: Cardiovascular prevention was left in second place during the COVID-19 pandemic and the use of telemedicine turned out to be very useful. We aimed to evaluate the effectiveness of a telemedicine application for remote monitoring and treatment adjustments in terms of improving cardiovascular prevention. (2) Methods: A prospective study of 3439 patients evaluated between the 1st of March 2019 and the 1st of March 2022, in the pre-pandemic period by face-to-face visits and during the pandemic by teleconsultations or hybrid follow-up. We compared four periods: pre-pandemic—Pre-P (1 March 2019–1 March 2020), lockdown—Lock (1 March–1 September 2020), restrictive-pandemic—Restr-P (1 September 2020–1 March 2021), and relaxed–pandemic—Rel-P (1 March 2021–1 March 2022). (3) Results: The average values of total cholesterol (TC), LDL cholesterol, triglycerides, uric acid, and glucose had an increasing trend during Lock and Restr-P, and they decreased close to the baseline level during the Rel-P, with the exception of glucose which remained elevated in Rel-P. The number of patients with newly discovered DM increased significantly in the Rel-P, and 79.5% of them had mild/moderate forms of COVID-19. During Lock and Res-P, the percentage of obese, smoking, or hypertensive patients increased, but probably through the use of telemedicine, we managed to reduce it, although it remained slightly higher than the pre-pandemic level. Physical activity decreased in the first year of the pandemic, but in Rel-P people became more active than before the pandemic. (4) Conclusions: The use of telemedicine for cardiovascular prevention seems to yield favorable results, especially for secondary prevention in the very high-risk group and during the second year. Full article

(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)

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Open AccessArticle

The Emergency Performance of the Hungarian Ambulance Service during the COVID-19 Pandemic

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Healthcare 2022, 10(11), 2331; https://doi.org/10.3390/healthcare10112331 - 21 Nov 2022

Cited by 2 | Viewed by 1214

Abstract

The COVID-19 pandemic had a considerable impact on the whole health sector, particularly on emergency services. Our aim was to examine the performance of the Hungarian National Ambulance Service during the first four waves of the pandemic. We defined the 2019 performance of the service as the baseline and compared it with the activity during the pandemic years of 2020 and 2021. The data contained deliveries related to acute myocardial infarction, hemorrhagic stroke, ischemic stroke, overall non-COVID-related ambulance deliveries, COVID screenings performed by the ambulance service, and COVID-related ambulance deliveries. The data were aggregated for each week of the investigated time period and stratified by gender and age. Compared with the pre-pandemic era, we found a significant increase in all three medical conditions and overall deliveries (p < 0.001 in all cases). As a result of the increased burden, it is important for emergency services to prepare for the next global epidemic and to improve organizational performance and rescue activities. The Hungarian example highlights that in a pandemic, it can be beneficial to organize the emergency care of a country or a larger region under a single provider with a single decision maker supported by business intelligence. Full article

(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)

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Open AccessArticle

Design and Development of Smart Weight Measurement, Lateral Turning and Transfer Bedding for Unconscious Patients in Pandemics

Imran Shafi

Muhammad Siddique Farooq

Isabel De La Torre Díez

Jose Breñosa

Julio César Martínez Espinosa

and

Imran Ashraf

Healthcare 2022, 10(11), 2174; https://doi.org/10.3390/healthcare10112174 - 30 Oct 2022

Cited by 1 | Viewed by 1807

Abstract

Patient care and convenience remain the concern of medical professionals and caregivers alike. An unconscious patient confined to a bed may develop fluid accumulation and pressure sores due to inactivity and deficiency of oxygen flow. Moreover, weight monitoring is crucial for an effective treatment plan, which is difficult to measure for bedridden patients. This paper presents the design and development of a smart and cost-effective independent system for lateral rotation, movement, weight measurement, and transporting immobile patients. Optimal dimensions and practical design specifications are determined by a survey across various hospitals. Subsequently, the proposed hoist-based weighing and turning mechanism is CAD-modeled and simulated. Later, the structural analysis is carried out to select suitable metallurgy for various sub-assemblies to ensure design reliability. After fabrication, optimization, integration, and testing procedures, the base frame is designed to mount a hydraulic motor for the actuator, a DC power source for self-sustenance, and lockable wheels for portability. The installation of a weighing scale and a hydraulic actuator is ensured to lift the patient for weight measuring up to 600 pounds or lateral turning of 80 degrees both ways. The developed system offers simple operating characteristics, allows for keeping patient weight records, and assists nurses in changing patients’ lateral positions both ways, comfortably massage patients’ backs, and transport them from one bed to another. Additionally, being lightweight offers reduced contact with the patient to increase the healthcare staff’s safety in pandemics; it is also height adjustable and portable, allowing for use with multiple-sized beds and easy transportation across the medical facility. The feedback from paramedics is encouraging regarding reducing labor-intensive nursing tasks, alleviating the discomfort of long-term bed-ridden patients, and allowing medical practitioners to suggest better treatment plans. Full article

(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)

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Open AccessArticle

Changes in Daily Life, Physical Activity, GAD, Depression, and Personal Hygiene of Adolescents in South Korea Due to the COVID-19

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Healthcare 2022, 10(10), 1881; https://doi.org/10.3390/healthcare10101881 - 27 Sep 2022

Cited by 2 | Viewed by 1083

Abstract

This study used raw data obtained from the Adolescents’ Health Behavior Survey by government-affiliated agency open data. A total of 109,796 students were sampled. A comparative analysis was performed based on the year 2020 and when the COVID-19 pandemic occurred, in which we analyzed changes in adolescents’ depression and panic anxiety perception and dietary habits, physical factors, physical activity, and handwashing habits. There was no weight control in the second year compared to the first year of the COVID-19 pandemic, and obesity also increased. The continuation of the non-contact situation caused by COVID-19 led to a worsening of subjective health awareness, and the experience of generalized anxiety disorder, depression, sadness and hopelessness, and suicidal thoughts and attempts increased. The frequency of washing hands with soap before meals and after using the toilet at school or at home was reduced. As a result of this analysis, we believe that there needs to be a system of support in place to address the academic gaps and deficiencies in learning caused by COVID-19, and that psychological and emotional support needs to be strengthened at this time, as well as the issues to be supported after the end of the non-contact situation. Full article

(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)

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