Role Orientation and Pathway of Primary Care during Containing COVID-19：a Case Study of Shanghai W Community Health Center

doi:10.12114/j.issn.1007-9572.2021.00.187

Abstract

Abstract: Background　Primary care has played an significant role in containing COVID-19. But there is a lack of studies on the mechanism and pathway of its action. Objective　To explore the role of primary care during the containment of COVID-19，and to map the systematic pathway. Methods　This study was conducted between February and March 2020 in W Community Health Center（CHC），Shanghai. Data about major measures taken by center for containing COVID-19 were collected via interviews by telephone，email，WeChat voice，or key informant，and were analyzed to examine the role orientation of this CHC and to map its systematic pathway in containing the pandemic using system dynamics diagram. Results　The major actions taken by this CHC to contain COVID-19 included：establishing a COVID-19 containment management team，implementing COVID-19 screening and triage，undertaking emergency responses to COVID-19，strengthening ward management，and providing online health services. This CHC's role during COVID-19 containment was mainly summarized as: providing essential healthcare services for residents，undertaking the anti-COVID-19 tasks assigned by higher level institutions，delivering community-based anti-COVID-19 services，and parallelly cooperating with other relevant institutions. The system dynamics flow diagram showed that the CVID-19 containment system in primary care based on the practice of this CHC is composed of four subsystems: execution path，emergency path，cooperation path，and essential healthcare service path. Conclusion　Our study indicates that primary care plays an important role in COVID-19 containment，which may be summarized as "implementing duties in collaboration with other relevant institutions using parallel or vertical mode"，and recommendations for the implementation may be summarized as "providing essential healthcare services for residents，strengthening the organization and management of anti-COVID-19 services delivery，enhancing team building and improving the cooperation with other institutions".

Key words: Primary healthcare institution, Epidemic prevention and control, COVID-19, Community health center

摘要： 背景　基层医疗卫生机构在此次新型冠状病毒肺炎疫情防控中发挥着重要作用，但其在疫情防控中的作用路径与机制研究还比较缺乏。目的　本文旨在探讨基层医疗卫生机构在新型冠状病毒肺炎疫情防控中的功能定位，并刻画其发挥作用的系统路径。方法　2020年2—3月以上海市W社区卫生服务中心为例，采用邮件访谈、微信语音访谈与关键人物访谈搜集基层医疗卫生机构在疫情期间的主要措施，探索基层医疗卫生机构在疫情防控中的功能定位，并通过绘制系统动力学流图刻画基层医疗卫生机构的系统路径。结果　W社区卫生服务中心在疫情期间采取的主要措施包括组建疫情管理团队、实施分诊筛查、落实应急响应、强化病房管理、开展线上医疗，其主要功能定位包括“守住基本”“承接上线”“对接社区”“左右协同”4个方面。系统动力学流图显示，基层医疗卫生机构疫情防控系统主要由“执行路径”“应急路径”“协同路径”“基本医疗服务路径”4个子系统构成。结论　基层医疗卫生机构在重大疫情防控中发挥着重要作用，可概括为“上下左右”的功能定位。守住基本、加强组织管理、强化团队建设与提升外部协同是相应的政策建议。

关键词: 基层医疗卫生机构, 疫情防控, 新型冠状病毒肺炎, 社区卫生服务中心

HUANG Jiaoling,FU Xuanqin,WANG Liqiang, et al. Role Orientation and Pathway of Primary Care during Containing COVID-19：a Case Study of Shanghai W Community Health Center　[J]. Chinese General Practice, 2021, 24(13): 1596-1601. DOI: 10.12114/j.issn.1007-9572.2021.00.187.
黄蛟灵,傅玄琴,王黎强等. 基层医疗卫生机构在疫情防控中的功能定位与作用路径研究：以上海市W社区卫生服务中心为例[J]. 中国全科医学, 2021, 24(13): 1596-1601. DOI: 10.12114/j.issn.1007-9572.2021.00.187.

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