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Suplementum 287: Abstracts of the of the joint annual meeting of the Swiss Society of Cardiology and the Swiss Society of Cardiac Surgery (Zurich, Switzerland, June 4-6, 2025). 补编287:瑞士心脏病学会和瑞士心脏外科学会联合年会摘要(苏黎世,瑞士,2025年6月4-6日)。
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-28 DOI: 10.57187/s.4706
Swiss Society Of Cardiology, Swiss Society Of Cardiac Surgery
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引用次数: 0
Evolution of adult respiratory syncytial virus detection: impact of testing strategy changes and pandemic-related measures at a Swiss regional hospital, 2016-2023. 2016-2023年瑞士某地区医院成人呼吸道合胞病毒检测的演变:检测策略变化和大流行相关措施的影响
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-20 DOI: 10.57187/s.4324
Annika Bonin, Robert Escher, Neal Breakey
{"title":"Evolution of adult respiratory syncytial virus detection: impact of testing strategy changes and pandemic-related measures at a Swiss regional hospital, 2016-2023.","authors":"Annika Bonin, Robert Escher, Neal Breakey","doi":"10.57187/s.4324","DOIUrl":"https://doi.org/10.57187/s.4324","url":null,"abstract":"<p><strong>Background and aims: </strong>Respiratory syncytial virus (RSV) is increasingly recognised as an important cause of respiratory illness in adults. We aimed to analyse clinical and epidemiological characteristics of patients with a positive reverse transcription-polymerase chain reaction (RT-PCR) test in a Swiss regional hospital between 2016 and 2023, including predisposing factors, patient demographics, treatment approaches and clinical outcomes. We also examined temporal patterns of RSV detection during periods of changes in testing strategies and public health measures.</p><p><strong>Methods: </strong>In this retrospective cohort study at Spital Emmental, we analysed all consecutive in- and outpatients with respiratory symptoms who underwent nasopharyngeal RT-PCR testing following local syndrome-based testing protocols between December 2016 and February 2023. The testing methodology changed from trivalent (influenza A/B, RSV) to quadrivalent (SARS-CoV-2, influenza A/B, RSV) RT-PCR in March 2022, with simultaneous expansion of the testing criteria. Temporal patterns and incidence of positive RSV tests relating to periods of national COVID-19-related public health measures (13 March 2020 and 17 February 2022) were assessed.</p><p><strong>Results: </strong>Of 8135 RT-PCR tests performed, 231 (2.8%) were positive for RSV. The mean age was 69 years, with complete clinical data available for 194 patients. Of these, 157 (81%) required hospitalisation, of whom 19 (12%) were classified as nosocomial infections. Of the hospitalised patients, 14 (9%) required intensive care, with an in-hospital mortality rate of 6%. Major comorbidities in inpatients included cardiac disease (54%), pulmonary disease (49%) and anaemia (43%). Testing patterns showed marked temporal variation: 1766 tests (22%) were performed pre-pandemic, 125 (1%) during pandemic measures and 6244 (77%) after pandemic restrictions were lifted. The introduction of quadrivalent testing in March 2022 led to an increase in testing volume, but lower positivity rates (6% pre- vs 2% post-implementation).</p><p><strong>Conclusions: </strong>Our results demonstrate RSV-associated resource use and mortality in adults. The temporal evolution of RSV detection in our cohort paralleled changes in testing practices, highlighting the complex interplay between diagnostic strategies and observed disease patterns in a regional hospital setting. Recently introduced preventive vaccination strategies may help to address the impact on patients and healthcare resource utilisation.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4324"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment goals indicate palliative care hospital costs: a longitudinal economic study. 治疗目标表明姑息治疗医院成本:一项纵向经济研究。
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-20 DOI: 10.57187/s.4132
Monika Hagemann, Barbara Janina Kidszun, Matthias Schwenkglenks, Odile Stalder, Steffen Eychmüller, Maud Maessen
{"title":"Treatment goals indicate palliative care hospital costs: a longitudinal economic study.","authors":"Monika Hagemann, Barbara Janina Kidszun, Matthias Schwenkglenks, Odile Stalder, Steffen Eychmüller, Maud Maessen","doi":"10.57187/s.4132","DOIUrl":"https://doi.org/10.57187/s.4132","url":null,"abstract":"<p><strong>Study aims: </strong>Although costs for inpatient palliative care have been widely studied, heterogeneity of patient needs in specialist palliative care challenges health scientists. A framework reflecting various treatment goals in daily clinical practice may help cluster patients with different care needs reasonably and account for such diversity of costs. The aim of this study was to show whether the care type framework reflects associated costs for different care needs in patients receiving specialist palliative care in a Swiss university hospital.</p><p><strong>Methods: </strong>We performed a retrospective, observational analysis of hospital costs using administrative data from a Swiss university hospital of all specialist palliative care inpatients in the period 2016-2022. Patients were classified at admission into four different palliative care types reflecting treatment goals: care type 1: extensive palliative care needs (biopsychosocial-spiritual), goal = stabilisation and setting of realistic goals; care type 2: mobility evaluation and training, goal = return home; care type 3: focused symptom management, goal = symptom relief; care type 4: care for dying patients, goal = dying with dignity. We used a generalised linear model assuming gamma-distributed errors and with a logarithmic link function, adjusted by inverse probability weighting to adjust for differences in patient characteristics. We hypothesised that patients - classified into one of four care types based on treatment goals - differed substantially by cost, with care type 1 being most expensive.</p><p><strong>Results: </strong>Of 1099 included patients, overall unadjusted median costs per patient during specialist palliative care treatment were CHF 20,253 (interquartile range [IQR] 12,327-30,104). Median costs (% of total patients; median length of stay) by care type were: CHF 23,999 for care type 1 (44%; 13 days); CHF 21,598 for care type 2 (9%; 14 days); CHF 17,946 for care type 3 (24%; 12 days); and CHF 14,997 for care type 4 (23%; 8 days). Patients showed clearly different adjusted overall costs and adjusted daily costs by care type. Overall potential mean costs were the lowest for care type 4 (CHF 21,908) and clearly different (-15%) from the most expensive care type 1 (CHF 25,827). In contrast, potential mean daily adjusted costs were the most expensive for care type 4 (CHF 2361). Most daily costs for care type 4 (88%) belonged to the cost category \"staff costs\" (CHF 2070) of which 59% (CHF 1229) were nursing costs.</p><p><strong>Conclusion: </strong>Based on distinct treatment goals, care types provide an important yet - until now - missing explanatory framework for clustering hospital costs of specialist palliative care. Patients hospitalised in specialist palliative care units clearly differ regarding costs and cost categories, depending on care type.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4132"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Supplementum 286: Abstracts of the of the annual meeting of the Swiss Society of Paediatrics (May 22/23, 2025). 附录286:瑞士儿科学会年会摘要(2025年5月22日/23日)。
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-16 DOI: 10.57187/s.4676
Swiss Society Of Paediatrics
{"title":"Supplementum 286: Abstracts of the of the annual meeting of the Swiss Society of Paediatrics (May 22/23, 2025).","authors":"Swiss Society Of Paediatrics","doi":"10.57187/s.4676","DOIUrl":"https://doi.org/10.57187/s.4676","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4676"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Demographic distribution and injury patterns of ankle physeal fractures in children: a retrospective cohort study. 儿童踝关节骨骺骨折的人口分布和损伤模式:一项回顾性队列研究。
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-16 DOI: 10.57187/s.4265
Silvia Valisena, Giacomo De Marco, Oscar Vazquez, Anne Tabard-Fougère, Nastassia Guanziroli-Pralong, Christina Steiger-Tuc, Romain Olivier Dayer, Dimitri Ceroni
{"title":"Demographic distribution and injury patterns of ankle physeal fractures in children: a retrospective cohort study.","authors":"Silvia Valisena, Giacomo De Marco, Oscar Vazquez, Anne Tabard-Fougère, Nastassia Guanziroli-Pralong, Christina Steiger-Tuc, Romain Olivier Dayer, Dimitri Ceroni","doi":"10.57187/s.4265","DOIUrl":"https://doi.org/10.57187/s.4265","url":null,"abstract":"<p><strong>Introduction: </strong>Ankle physeal fractures are a significant concern in paediatric populations due to their potential to cause growth disturbances, including premature physeal closure. The present study aimed to describe the epidemiology and injury patterns of ankle physeal fractures in children treated at a single university hospital centre in Switzerland over a 19-year period.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included children aged 0 to 16 years who were admitted to our institution for an ankle physeal fracture between January 2004 and April 2023. Demographic and radiological data were collected, and fractures were classified according to the Salter-Harris and Dias-Tachdjian classifications. Statistical analyses, including Fisher's exact test, were performed for dichotomous outcomes, with significance set at p<0.05.</p><p><strong>Results: </strong>We included 259 patients with a mean age of 12.3 years old, mostly males (58.7%), with most fractures occurring among boys aged 14 and girls aged 12. Sports-related activities accounted for 51% of fractures, with the highest incidence in autumn. Isolated fractures of the distal tibia were most common (47.1%), and Salter-Harris type II fractures represented 51% of cases (p <0.05). The predominant mechanism of injury was supination-plantar flexion (33.6%).</p><p><strong>Conclusion: </strong>This study provided a comprehensive overview of the distribution and patterns of paediatric ankle physeal fractures. It underscored the need for future prospective multicentre studies to explore causative factors and outcomes related to growth disturbances. Targeted prevention and management strategies may help mitigate the incidence and consequences of these injuries.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4265"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of intermediate airway management on ventilation parameters in simulated paediatric out-of-hospital cardiac arrest: a multicentre randomised crossover trial. 模拟儿科院外心脏骤停时,中间气道管理对通气参数的影响:一项多中心随机交叉试验
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-16 DOI: 10.57187/s.4079
Loric Stuby, Laurent Bourgeois, Jean-Marie Tinembart, Elisa Mühlemann, David Thurre, Johan N Siebert, Laurent Suppan
{"title":"Effect of intermediate airway management on ventilation parameters in simulated paediatric out-of-hospital cardiac arrest: a multicentre randomised crossover trial.","authors":"Loric Stuby, Laurent Bourgeois, Jean-Marie Tinembart, Elisa Mühlemann, David Thurre, Johan N Siebert, Laurent Suppan","doi":"10.57187/s.4079","DOIUrl":"https://doi.org/10.57187/s.4079","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric out-of-hospital cardiac arrest survival rates remain low despite advancements in resuscitation science. Prompt restoration of oxygenation is crucial for achieving return of spontaneous circulation. Delays in airway management are associated with decreased survival rates. The primary objective of this study was to determine whether early i-gel® insertion, without prior bag-valve-mask, could enhance ventilation parameters in comparison with a bag-valve-mask-only approach.</p><p><strong>Methods: </strong>This multicentre, randomised crossover study used a simulated paediatric out-of-hospital cardiac arrest model to compare standard American Heart Association guidelines with an intermediate airway management approach using an i-gel® device. Paramedics and emergency medical technicians from eight participating emergency medical service centres were randomised into teams and performed two 10-minute simulations. Each team employed one of the airway management strategies. Data was automatically collected by a high-fidelity manikin. The primary outcome was alveolar ventilation per minute. Secondary outcomes included metrics for ventilation quality and timing, chest compression performance and timing of adrenaline administration. Statistical analysis involved paired tests suitable for the crossover design.</p><p><strong>Results: </strong>From 30 January 2023 to 13 June 2023, 68 participants formed 34 resuscitation teams. Minute alveolar ventilation was similar between intermediate airway management and bag-valve-mask strategies (difference: 36 ml [95% CI -28 to 99]). A sensitivity analysis showed comparable results. Intermediate airway management delivered more ventilations, but bag-valve-mask enabled quicker ventilation initiation and more ventilations within the target volume. Chest compression fraction was higher with intermediate airway management, although chest recoil was better with bag-valve-mask. Adrenaline administration rates and times were similar in both strategies. Minor protocol deviations were observed but did not introduce significant bias. The study was underpowered due to an error in the sample size calculation, limiting the robustness and generalisability of the findings.</p><p><strong>Conclusion: </strong>In a simulated paediatric out-of-hospital cardiac arrest model, immediate use of intermediate airway management did not show relevant differences compared to bag-valve-mask. Intermediate airway management devices cannot be recommended as first-line choice but may be considered when bag-valve-mask is challenging. Whichever device is used, the focus should remain on providing high-quality ventilations.</p><p><strong>Clinicaltrials: </strong>gov ID: NCT05498402.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4079"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mediation effects of attitudes on the generational and gender influence on Swiss General Practitioners' home visits: a cross-sectional study. 态度对瑞士全科医生家访的代际和性别影响的中介作用:一项横断面研究。
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-15 DOI: 10.57187/s.4039
Serena Petrocchi, Qianfeng Lu, Luca Gabutti, Sandro Bonetti, Mjriam Rodella Sapia, Franco Denti, Mario Bianchetti, Peter Schulz
{"title":"Mediation effects of attitudes on the generational and gender influence on Swiss General Practitioners' home visits: a cross-sectional study.","authors":"Serena Petrocchi, Qianfeng Lu, Luca Gabutti, Sandro Bonetti, Mjriam Rodella Sapia, Franco Denti, Mario Bianchetti, Peter Schulz","doi":"10.57187/s.4039","DOIUrl":"https://doi.org/10.57187/s.4039","url":null,"abstract":"<p><strong>Background: </strong>In family medicine, home visits are a tangible manifestation of patient-centred care, allowing physicians to comprehensively understand patients' circumstances and cater to their medical and psychosocial needs. However, a recent decline in general practitioner home visits has raised significant concerns about the potential impact on care quality, particularly for older patients. General practitioners' age, gender and attitudes may play a role. Attitudes refer to positive or negative thinking or feelings about something typically reflected in a person's behaviour.</p><p><strong>Aims: </strong>To study the effects of age and gender (i.e. predictors) on the number of home visits conducted during a typical week of work (i.e. outcome) by general practitioners in Canton Ticino, Switzerland. To investigate whether attitudes (i.e. mediators) mediate the relationship between age and home visits, controlling for gender.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from June to October 2023 on 142 family doctors (28% women) with an average age of 56.42 years (standard deviation [SD] = 11.51, range 36-83). Correlations between variables and a t-test with gender were conducted. A mediation analysis was performed to examine the potential association in which the attitudes may mediate the relationship between age and home visits, controlling for gender.</p><p><strong>Results: </strong>Older physicians conducted more home visits in a typical week (r = 0.32, p <0.001) than younger physicians, while female doctors conducted fewer visits (M = 2.39±1.8) than males (M = 4.09±2.9), t(100.8) = 3.77, p <0.001. The mediation analysis suggested that younger general practitioners tend to have more negative attitudes towards home visits, which in turn leads to a decrease in the number of home visits they make in a typical week (indirect effect B = 0.02).</p><p><strong>Conclusion: </strong>There is a generational and gender effect on home visit practice in family medicine. Moreover, younger doctors hold more negative attitudes towards home visits.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4039"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Persistent opioid use among patients who underwent intermediate-to-major elective surgery at a Swiss cantonal hospital: a prospective cohort study. 在瑞士一家州立医院接受中大型择期手术的患者持续使用阿片类药物:一项前瞻性队列研究
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-15 DOI: 10.57187/s.4152
Flavia Breitenmoser, Aaron Rixecker, Rahel Naef, Pascal Probst, Nils Horn, Markus K Müller, Alexander Dullenkopf, JoEllen Welter
{"title":"Persistent opioid use among patients who underwent intermediate-to-major elective surgery at a Swiss cantonal hospital: a prospective cohort study.","authors":"Flavia Breitenmoser, Aaron Rixecker, Rahel Naef, Pascal Probst, Nils Horn, Markus K Müller, Alexander Dullenkopf, JoEllen Welter","doi":"10.57187/s.4152","DOIUrl":"https://doi.org/10.57187/s.4152","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study aim: &lt;/strong&gt;To investigate the extent of persistent opioid use among patients undergoing intermediate-to-major elective surgery at a Swiss cantonal hospital and as a secondary aim to identify factors potentially predictive of persistent opioid use (6 to 12 weeks after surgery).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;For this single-centre prospective cohort study, all consecutive patients undergoing elective primary hip arthroplasty, partial or complete prostatectomy, caesarean delivery, spinal surgery, intermediate-to-major visceral surgery or major hand surgery were screened for enrolment from June 2022 to May 2023. We collected basic demographic and medical data, perioperative opioid use (converted to morphine milligram equivalents), postoperative complications, and opioid prescriptions issued by the hospital or other healthcare providers. Telephone interviews about opioid use were conducted with patients 6 weeks after surgery. Only those patients who were still taking opioids at the 6-week interview were contacted 12 weeks after surgery. The primary endpoint was the rate of persistent opioid use 6 or 12 weeks after surgery, and the secondary endpoints were (a) the percentage of patients who received and reported filling prescriptions, and (b) the type and amount of opioids dispensed. With persistent opioid use as the dependent variable, bivariate (predictors: pain or preoperative morphine milligram equivalent) and multivariate logistic regression models were used to assess associations (predictors: age, sex, ASA [American Society of Anesthesiologists] score, preoperative pain).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 855 patients were included in the main analysis. Median age was 62 years (interquartile range [IQR] 45-73), 52% were male and postsurgical complications occurred in 51 patients (6%). Fifty-six patients (7%) were preoperative opioid users. At discharge, 40 patients (5%) received an opioid prescription. Of the 724 patients who completed the 6-week follow-up interview, 30 (4%) had filled an opioid prescription (17 hospital-issued, 9 from an external source and 4 from both). Of the 30 patients (4%) who took opioids, the median length of consumption was 7 days (IQR 3-18). Seventeen patients (2%, 9 preoperative users) were taking opioids after 6 weeks. Seven of these 724 patients (1%, 5 preoperative users) continued use at 12 weeks postoperatively. Bivariate logistic regression analyses showed preoperative pain levels (at rest and during movement) were associated with persistent opioid use (odds ratio [OR] 1.27, 95% confidence interval [CI]: 1.11-1.46, p = 0.001; OR 1.3, 95% CI: 1.12-1.5, p = 0.001, respectively), as were 6-week postoperative pain levels (OR 1.96, 95% CI: 1.61-2.39, p &lt;0.0001; OR 1.82, 95% CI: 1.52-2.18, p &lt;0.0001, respectively). The median preoperative morphine milligram equivalent of persistent opioid users was 60 (IQR 30-180) versus 22.5 (IQR 15-30) in non-persistent users (p = 0.0155). There was a sl","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4152"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Did the COVID-19 pandemic impact paediatric health service utilisation in Switzerland? Interrupted time-series models of health insurance data. COVID-19大流行是否影响了瑞士儿科卫生服务的利用?健康保险数据的中断时间序列模型。
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-15 DOI: 10.57187/s.3899
Michelle Dey, Thomas Volken, Szilvia Altwicker-Hámori, Michael Von Rhein, Michelle Seiler, Ursula Laasner, Frank Wieber, Julia Dratva
{"title":"Did the COVID-19 pandemic impact paediatric health service utilisation in Switzerland? Interrupted time-series models of health insurance data.","authors":"Michelle Dey, Thomas Volken, Szilvia Altwicker-Hámori, Michael Von Rhein, Michelle Seiler, Ursula Laasner, Frank Wieber, Julia Dratva","doi":"10.57187/s.3899","DOIUrl":"https://doi.org/10.57187/s.3899","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of studies that examined the impact of the COVID-19 pandemic on different primary paediatric health services beyond the first pandemic year and with longitudinal analytical approaches. Concerning Switzerland, studies are also lacking that assessed the impact of the pandemic on primary paediatric health services with objective and representative data. The current study addresses these research gaps.</p><p><strong>Methods: </strong>Representative Swiss health insurance data (covering 96% of the population) of 0-18-year-olds, aggregated by month and by age groups 0-5, 6-10, 11-15 and 16-18 years were used for the analyses. The study period was from January 2018 to March 2022. Interrupted time-series models were applied to compare pandemic and pre-pandemic health care utilisation. The first lockdown served as the point of differentiation between these two periods. Regular visits, urgent visits, well-child visits and telephone consultations as well as routine vaccinations in the primary care setting were used as outcomes.</p><p><strong>Results: </strong>Among 0-5-year-olds, the average utilisation rates of regular, urgent and well-child visits were statistically significantly lower during the pandemic compared to the pre-pandemic period. This decrease in utilisation was primarily due to an initial marked drop after the lockdown, followed by a partial recovery during the pandemic phase. Additionally, the average vaccination rates for measles/mumps/rubella were statistically significantly lower during the pandemic for this age group, without indication of a catch-up over the pandemic phase. For 6-10-year-olds, a decreased average utilisation of regular and urgent visits was found without a statistically significant recovery over the pandemic period. No statistically significant changes were shown for older age groups regarding regular or urgent visits. However, telephone consultations showed statistically significantly higher average utilisation rates during the pandemic compared to the pre-pandemic phase across all age groups.</p><p><strong>Conclusions: </strong>Delayed or missed well-child visits, which might persist even after a certain recovery, pose the risk of delayed detection of clinical/developmental abnormalities. Furthermore, missed vaccinations for measles/mumps/rubella increase the likelihood of infections and outbreaks, which can be particularly dangerous for the youngest children. Therefore, promoting catch-up well-child visits and vaccinations is essential. Higher utilisation of telephone consultations during the pandemic may have partially compensated the underutilisation of face-to-face consultations/visits in young children. In adolescents, in whom no changes in the utilisation of face-to-face consultations were observed, the increased use of telephone consultations may indicate an increase in health concerns within this age group.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3899"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suplementum 285: Abstracts of the of the 9th Annual Spring Congress of the Swiss Society of General Internal Medicine (Basel, Switzerland, May 21-23, 2025). 附录285:瑞士普通内科学会第九届春季年会(巴塞尔,瑞士,2025年5月21-23日)摘要。
IF 2.1 4区 医学
Swiss medical weekly Pub Date : 2025-05-13 DOI: 10.57187/s.4571
Swiss Society Of General Internal Medicine
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