Abstract
BackgroundGPs play a major role in influenza epidemics, and most patients with influenza-like-illness (ILI) are treated in general practice or by primary care doctors on duty in out-of-hours services (OOH). Little is known about the surge capacity in primary care services during an influenza pandemic, and how the relationship between them changes.AimTo investigate how general practice and OOH services were used by patients during the 2009 pandemic in Norway and the impact of the pandemic on primary care services in comparison to a normal influenza season.MaterialsData from electronic remuneration claims from all OOH doctors and regular GPs for 2009.MethodsWe conducted a registry-based study of all ILI consultations in the 2009 pandemic with the 2008/09 influenza season (normal season) as baseline for comparison.ResultsThe majority (82.2%) of ILI consultations during the 2009 pandemic took place in general practice. The corresponding number in the 2008/09 season was 89.3%. Compared with general practice, the adjusted odds ratio for ILI with all other diagnoses as reference in OOH services was 1.23 (95% CI, 1.18, 1.27) for the 2008/2009 season and 1.87 (95% CI, 1.84, 1.91) for the pandemic influenza season. In total there was a 3.3-fold increase in ILI consultations during the pandemic compared to the 2008/09 season. A 5.5-fold increase of ILI consultations were observed in OOH services in comparison to the 2008/09 season. Children and young adults with ILI were the most frequent users of OOH services during influenza periods.ConclusionsThe autumn pandemic wave resulted in a significantly increased demand on primary care services. However, GPs in primary care services in Norway showed the ability to increase capacity in a situation with increased patient demand.
Highlights
Influenza epidemics occur almost every winter in the northern hemisphere [1,2]
The adjusted odds ratio for ILI with all other diagnoses as reference in out-of-hours services (OOH) services was 1.23 for the 2008/2009 season and 1.87 for the pandemic influenza season
We examined data from electronic remuneration claims from all OOH doctors and regular general practitioners (GPs) for 2009
Summary
In April 2009 a new influenza virus characterized as a pandemic strain infected and spread rapidly in Mexico and USA [3]. Norwegian health authorities have estimated that approximately 900,000 individuals out of a population of approximately 5 million were infected, and 32 laboratory confirmed deaths were reported [6]. Oseltamivir was released at pharmacies as an over-the-counterdrug for influenza-like-illness (ILI). Despite these measures, a large number of ILI consultations took place in general practice or outof-hours (OOH) services during the pandemic. GPs play a major role in influenza epidemics, and most patients with influenza-like-illness (ILI) are treated in general practice or by primary care doctors on duty in out-of-hours services (OOH). Little is known about the surge capacity in primary care services during an influenza pandemic, and how the relationship between them changes
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