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

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 an...

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Main Authors: Kristjan Linnet, Johann Agust Sigurdsson, Margret Olafia Tomasdottir, Emil Larus Sigurdsson, Anna Bryndis Blondal, Jon Steinar Jonsson, Hannes Hrafnkelsson
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/12/e043151.full
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author Kristjan Linnet
Johann Agust Sigurdsson
Margret Olafia Tomasdottir
Emil Larus Sigurdsson
Anna Bryndis Blondal
Jon Steinar Jonsson
Hannes Hrafnkelsson
author_facet Kristjan Linnet
Johann Agust Sigurdsson
Margret Olafia Tomasdottir
Emil Larus Sigurdsson
Anna Bryndis Blondal
Jon Steinar Jonsson
Hannes Hrafnkelsson
author_sort Kristjan Linnet
collection DOAJ
description 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.
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spelling doaj-art-e4aa851e1a0b4be297a347a2d83b2ffa2025-08-20T02:32:42ZengBMJ Publishing GroupBMJ Open2044-60552020-12-01101210.1136/bmjopen-2020-043151How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemicKristjan Linnet0Johann Agust Sigurdsson1Margret Olafia Tomasdottir2Emil Larus Sigurdsson3Anna Bryndis Blondal4Jon Steinar Jonsson5Hannes Hrafnkelsson6Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland1 Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, IcelandDepartment of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland1 Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, IcelandDevelopment Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, IcelandDepartment of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, IcelandDepartment of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, IcelandObjective 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.https://bmjopen.bmj.com/content/10/12/e043151.full
spellingShingle Kristjan Linnet
Johann Agust Sigurdsson
Margret Olafia Tomasdottir
Emil Larus Sigurdsson
Anna Bryndis Blondal
Jon Steinar Jonsson
Hannes Hrafnkelsson
How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
BMJ Open
title How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
title_full How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
title_fullStr How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
title_full_unstemmed How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
title_short How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic
title_sort how primary healthcare in iceland swiftly changed its strategy in response to the covid 19 pandemic
url https://bmjopen.bmj.com/content/10/12/e043151.full
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