How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic.

Autor:	Sigurdsson EL; Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland emilsig@hi.is.; Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland., Blondal AB; Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland.; Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland., Jonsson JS; Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.; Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland., Tomasdottir MO; Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.; Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland., Hrafnkelsson H; Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland., Linnet K; Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland., Sigurdsson JA; Faculty of Medicine, Department of Public Health and Nursing/General Practice Research Unit, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2020 Dec 07; Vol. 10 (12), pp. e043151. Date of Electronic Publication: 2020 Dec 07.
DOI:	10.1136/bmjopen-2020-043151
Abstrakt:	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. Competing Interests: Competing interests: None declared. (© 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.)
Databáze:	MEDLINE
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