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Objetivos: Conocer las características de la atención inicial y el seguimiento telefónico de pacientes con sospecha de COVID-19 en la primera ola de la pandemia. Diseño: Observacional retrospectivo (auditoría de historias clínicas).Emplazamiento: Centro de salud urbano. Participantes: Casos probables de SARS-CoV-2 (15/03/2020 a 15/06/2020). Mediciones principales Ámbito de atención inicial y seguimiento telefónico (número de llamadas y duración). Variables sociodemográficas (incluyendo estructura familiar). Curso clínico (sintomatología, vulnerabilidad, pruebas, ingreso hospitalario y desenlace). Resultados Trescientos uno pacientes (51,5 [±17,8] años, 23% vulnerables, 17% estructura familiar no nuclear). Valoración inicial en el centro de salud (59,8%: telefónica; 25,2%: presencial). En urgencias hospitalarias (11%) presentaron síntomas similares que en atención primaria, predominan estructuras familiares no nucleares (p<0,05; test χ2), realizando más pruebas (p<0,05; test χ2). En domicilio (3,9%) son pacientes ancianos vulnerables (p<0,01, test ANOVA). El seguimiento telefónico duró 17,1 [±10,3] días con 8,2 [±4,4] llamadas, superior si provenían de urgencias o domicilio (p<0,03; test ANOVA). Se incrementa tras ≥2 consultas presenciales (OR: 4,8), la presencia de síntomas de alarma (OR: 2,3) y la edad ≥45 años (OR: 2,0). Se realizaron pocas pruebas de confirmación (19,3% antigénicas, 13% serologías). El 15,3% ingresos hospitalarios (todos valorados en centros de salud), con 6,3% casos severos y 2,3% exitus. Conclusión Durante la primera ola de la pandemia, la población optó por ser atendida de forma telemática en su centro de salud. Las valoraciones iniciales en urgencias del hospital se relacionan con la falta de apoyo social, pero no con mayor gravedad clínica. El seguimiento telefónico fue aceptado por la población y permitió seleccionar a los pacientes con peor curso clínico.

ObjectiveTo know the characteristics of the initial care and telephone follow-up of patients with suspected COVID-19 in the first wave of the pandemic. Design: Observational, retrospective (audit of medical records).Location: Urban Primary Care Center of Andalusia (Spain). Participants: Probable cases of SARS-CoV-2 (from 20/03/15 to 20/06/15). Principal measurements Initial medical assessment (place and modality) and telephone follow-up (number of calls and duration). Sociodemographic variables (including family structure). Clinical course (symptoms, vulnerability, tests, hospital admission and outcome). Results Three hundred one patients (51.5±17.8 years; 23% vulnerable people; 17% non-nuclear family structure). First assessment in Primary Care by phone (59.8%) and face-to-face (25.2%). At the hospital emergency department (11%), patients were more frequently from non-nuclear families (P<.05 χ2) and more tests were carried out (P<.05 χ2) despite having similar symptoms. Vulnerable elderly patients needed home health care (P<.01 ANOVA). 8.2±4.4 follow-up phone calls were made per patient, for 17.1±10.3 days. It increases after ≥2 face-to-face consultations (OR 4.8), the presence of alarm symptoms (OR 2.3) and age ≥45 years (OR 2.0). Few confirmatory tests were performed (19.3% antigenic, 13% serology). The 15.3% hospital admissions (all assessed previously in Primary Care), with 6.3% severe cases and 2.3% death. Conclusion Population chose to be attended in Primary Care during the pandemic first wave, above all by phone. Telephone follow-up was well accepted and useful to select patients with serious complications. Initial medical assessment in the hospital emergency department was related to a lack of social support but not with greater clinical severity.

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OBJECTIVE: To know the characteristics of the initial care and telephone follow-up of patients with suspected COVID-19 in the first wave of the pandemic. DESIGN: Observational, retrospective (audit of medical records). LOCATION: Urban Primary Care Center of Andalusia (Spain). PARTICIPANTS: Probable cases of SARS-CoV-2 (from 20/03/15 to 20/06/15). PRINCIPAL MEASUREMENTS: Initial medical assessment (place and modality) and telephone follow-up (number of calls and duration). Sociodemographic variables (including family structure). Clinical course (symptoms, vulnerability, tests, hospital admission and outcome). RESULTS: Three hundred one patients (51.5±17.8 years; 23% vulnerable people; 17% non-nuclear family structure). First assessment in Primary Care by phone (59.8%) and face-to-face (25.2%). At the hospital emergency department (11%), patients were more frequently from non-nuclear families (P<.05 χ2) and more tests were carried out (P<.05 χ2) despite having similar symptoms. Vulnerable elderly patients needed home health care (P<.01 ANOVA). 8.2±4.4 follow-up phone calls were made per patient, for 17.1±10.3 days. It increases after ≥2 face-to-face consultations (OR 4.8), the presence of alarm symptoms (OR 2.3) and age ≥45 years (OR 2.0). Few confirmatory tests were performed (19.3% antigenic, 13% serology). The 15.3% hospital admissions (all assessed previously in Primary Care), with 6.3% severe cases and 2.3% death. CONCLUSION: Population chose to be attended in Primary Care during the pandemic first wave, above all by phone. Telephone follow-up was well accepted and useful to select patients with serious complications. Initial medical assessment in the hospital emergency department was related to a lack of social support but not with greater clinical severity.

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Objetivo: conocer las tasas de vacunación contra el virus del papiloma humano (VPH) y su relación con la estrategia vacunal y la pertenencia a zonas necesitadas de transformación social (ZNTS). Diseño: estudio descriptivo, auditoría de historias clínicas.Emplazamiento:cuatro centros de salud urbanos (2015-2018).Participantes:adolescentes susceptibles de vacunación contra el VPH.Mediciones principales:tasas vacunales de acceso, cobertura y deserción.Resultados:366 adolescentes (12-16 años). Tasas: acceso 85,5%; cobertura 77,6%; deserción 9,3%. A mayor edad, mejores tasas de acceso (odds ratio [OR]: 6,1) y cobertura (OR: 1,4). La vacunación en el centro de salud se relaciona con una mejor tasa de cobertura (OR: 12,7), pero aumenta significativamente la tasa de deserción (OR: 75,6). Vivir en ZNTS disminuye la tasa de deserción (OR: 0,6).Conclusiones:la vacunación en centros de salud mejora la tasa de cobertura, pero con mayor riesgo de no completar la vacunación. La tasa de deserción es menor en ZNTS.(AU)

Objective: To ascertain the vaccination coverage rates against human papillomavirus (HPV) and its relationship with the vaccination strategy and belonging to poverty areas.Design:Descriptive study, audit of medical records.Setting:Four urban Primary Care centres (2015-2018).Participants:Adolescents susceptible to HPV vaccination.Main measurements:Vaccination Access, Coverage and Dropout Rates.Results:366 adolescents (12-16 years). Vaccination Rates: Access 85.5%; Coverage 77,6% and Dropout 9,3%. The oldest adolescents had higher Access (OR 6,1) and Coverage Rates (OR 1,4). Vaccination at the Primary Care centre was associated with a better Coverage Rate (OR 12,7) but the Vaccine Dropout Rate (OR 75,6) significantly increased. Living in a poverty area led to a decrease in Dropout Rate (OR 0,6).Conclusions:Vaccination in Primary Care centres improved the coverage rate but with a higher risk of not completing the vaccination. Adolescents in poverty areas completed vaccination more frequently.(AU)

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