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

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


Title: How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
Author: Sigurdsson, Emil Larus
Blondal, Anna Bryndis
Jonsson, Jon Steinar
Tomasdottir, Margret Olafia
Hrafnkelsson, Hannes
Linnet, Kristjan   orcid.org/0000-0002-0189-9519
Sigurdsson, Johann Agust   orcid.org/0000-0002-5646-6411
Date: 2020-12-07
Language: English
Scope:
Department: Faculty of Medicine
Faculty of Pharmaceutical Sciences
Series: BMJ Open; 10(12)
ISSN: 2044-6055
DOI: https://doi.org/10.1136/bmjopen-2020-043151
Subject: COVID-19; epidemiology; infectious diseases; organisation of health services; primary care; Medicine (all)
URI: https://hdl.handle.net/20.500.11815/3422

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Citation:

Sigurdsson , E L , Blondal , A B , Jonsson , J S , Tomasdottir , M O , Hrafnkelsson , H , Linnet , K & Sigurdsson , J A 2020 , ' How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic ' , BMJ Open , vol. 10 , no. 12 , e043151 . https://doi.org/10.1136/bmjopen-2020-043151

Abstract:

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.

Description:

Funding Information: Contributors All authors contributed to the planning, conduct and reporting of the study. ELS, JSJ, MOT, HH, KL worked on acquisition of the data. ELS, ABB and JSJ drafted the manuscript with input from MOT, HH, KL and JAS which was critically reviewed by all the authors. HH performed the statistical analysis. ELS, ABB, JSJ, MOT, HH, KL, JAS read and approved the final version of the manuscript. Funding This research was supported by the Research Fund of the Icelandic College of Family Physicians. Publisher Copyright: ©

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