How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVE: To describe how the primary healthcare (PHC) in Iceland changed its strategy to handle the COVID-19 pandemic.
DESIGN: Descriptive observational study.
SETTING: Reykjavik, the capital of Iceland.
POPULATION: The Reykjavik area has a total of 233 000 inhabitants.
MAIN OUTCOME MEASURES: The number and the mode of consultations carried out. Drug prescriptions and changes in the 10 most common diagnoses made in PHC. Laboratory tests including COVID-19 tests. Average numbers in March and April 2020 compared with the same months in 2018 and 2019.
RESULTS: Pragmatic strategies and new tasks were rapidly applied to the clinical work to meet the foreseen healthcare needs caused by the pandemic. The number of daytime consultations increased by 35% or from 780 to 1051/1000 inhabitants (p<0.001) during the study period. Telephone and web-based consultations increased by 127% (p<0.001). The same tendency was observed in out-of-hours services. The number of consultations in maternity and well-child care decreased only by 4% (p=0.003). Changes were seen in the 10 most common diagnoses. Most noteworthy, apart from a high number of COVID-19 suspected disease, was that immunisation, depression, hypothyroidism and lumbago were not among the top 10 diagnoses during the epidemic period. The number of drug prescriptions increased by 10.3% (from 494 to 545 per 1000 inhabitants, p<0.001). The number of prescriptions from telephone and web-based consultations rose by 55.6%. No changes were observed in antibiotics prescriptions.
CONCLUSIONS: As the first point of contact in the COVID-19 pandemic, the PHC in Iceland managed to change its strategy swiftly while preserving traditional maternity and well-child care, indicating a very solid PHC with substantial flexibility in its organisation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
BMJ open - 10(2020), 12 vom: 07. Dez., Seite e043151 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sigurdsson, Emil Larus [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 21.12.2020 Date Revised 10.01.2021 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/bmjopen-2020-043151 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVE: To describe how the primary healthcare (PHC) in Iceland changed its strategy to handle the COVID-19 pandemic | ||
| 520 | |a DESIGN: Descriptive observational study | ||
| 520 | |a SETTING: Reykjavik, the capital of Iceland | ||
| 520 | |a POPULATION: The Reykjavik area has a total of 233 000 inhabitants | ||
| 520 | |a MAIN OUTCOME MEASURES: The number and the mode of consultations carried out. Drug prescriptions and changes in the 10 most common diagnoses made in PHC. Laboratory tests including COVID-19 tests. Average numbers in March and April 2020 compared with the same months in 2018 and 2019 | ||
| 520 | |a RESULTS: Pragmatic strategies and new tasks were rapidly applied to the clinical work to meet the foreseen healthcare needs caused by the pandemic. The number of daytime consultations increased by 35% or from 780 to 1051/1000 inhabitants (p<0.001) during the study period. Telephone and web-based consultations increased by 127% (p<0.001). The same tendency was observed in out-of-hours services. The number of consultations in maternity and well-child care decreased only by 4% (p=0.003). Changes were seen in the 10 most common diagnoses. Most noteworthy, apart from a high number of COVID-19 suspected disease, was that immunisation, depression, hypothyroidism and lumbago were not among the top 10 diagnoses during the epidemic period. The number of drug prescriptions increased by 10.3% (from 494 to 545 per 1000 inhabitants, p<0.001). The number of prescriptions from telephone and web-based consultations rose by 55.6%. No changes were observed in antibiotics prescriptions | ||
| 520 | |a CONCLUSIONS: As the first point of contact in the COVID-19 pandemic, the PHC in Iceland managed to change its strategy swiftly while preserving traditional maternity and well-child care, indicating a very solid PHC with substantial flexibility in its organisation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a infectious diseases | |
| 650 | 4 | |a organisation of health services | |
| 650 | 4 | |a primary care | |
| 700 | 1 | |a Blondal, Anna Bryndis |e verfasserin |4 aut | |
| 700 | 1 | |a Jonsson, Jon Steinar |e verfasserin |4 aut | |
| 700 | 1 | |a Tomasdottir, Margret Olafia |e verfasserin |4 aut | |
| 700 | 1 | |a Hrafnkelsson, Hannes |e verfasserin |4 aut | |
| 700 | 1 | |a Linnet, Kristjan |e verfasserin |4 aut | |
| 700 | 1 | |a Sigurdsson, Johann Agust |e verfasserin |4 aut | |
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