Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system
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ORIGINAL ARTICLE
Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province, Iran Nazila NeJhaddadgar 1 & Arash Ziapour 2
&
Ghader Zakkipour 3 & Jaffar Abbas 4 & Mitra Abolfathi 5 & Masoud Shabani 6
Received: 4 June 2020 / Accepted: 3 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aims Screening services for early detection of patients is one of the important capabilities of the health system with a proper referral system. In the crisis of respiratory infection of Covid-19, screening based on symptoms is one of the key measures. The aim of the current study was to evaluate the telephone-based screening and triage services in the promoted primary healthcare system with regard to the Covid-19 outbreak, in terms of reducing unnecessary referrals to the hospital. Methods This is a descriptive cross-sectional study conducted in two stages on 1,406,635 households during March/April 2020 in Ardabil province for screening and early detection of Covid-19 disease. In the first stage, conducted by trained healthcare providers through telephone, individuals suspected of Covid-19 were identified. In the second stage, the individuals were referred to the second level of service in comprehensive healthcare centers (16- or 24-h centers) for clinical evaluation by a physician. Results The results showed that before establishing a screening and triage system for patients in comprehensive healthcare centers, all patients were referred directly to the hospital, while after the implementation of the program, a significant reduction in hospital visits was observed and a large number of patients undertook the care and triage services in comprehensive healthcare centers. Conclusion The use of a grading system in referring patients with suspected cases, triage of patients according to symptoms at the comprehensive health centers, and activation of home isolation were the most important factors in reducing the burden of unnecessary referrals of patients to the hospital. Keywords Screening . Triage . Covid-19 . Comprehensive health centers
Introduction Acute respiratory infection caused by Covid-19 is one of the diseases with high transmission in the world today (Lai et al. * Masoud Shabani [email protected] Nazila NeJhaddadgar [email protected]
2020; WHO 2020). Due to its rapid transmission, the number of visits to hospitals and medical centers is increasing sharply (Wang et al. 2020). There is a strong relationship between the capacity of a health system and the mortality rate of patients 1
Department of Health Promotion and Education, Ardabil University of Medical Sciences, Ardabil, Iran
2
Health Education and Health Promotion, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
3
Fellowship of National Health & Treatment Network Management, Ardabil University of Medical Sciences, Ardabil, Iran
4
Antai College of Economics and Management/School of Media an
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