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Comparative Study
. 2013 Jul 18;8(7):e69408.
doi: 10.1371/journal.pone.0069408. Print 2013.

Capacity and adaptations of general practice during an influenza pandemic

Kristian A Simonsen  1 , Steinar Hunskaar, Hogne Sandvik, Guri Rortveit
Affiliations
Comparative Study

Capacity and adaptations of general practice during an influenza pandemic

Kristian A Simonsen et al. PLoS One. .

Abstract

Background: 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.

Aim: To 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.

Materials: Data from electronic remuneration claims from all OOH doctors and regular GPs for 2009.

Methods: We 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.

Results: The 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.

Conclusions: The 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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. ILI consultations in general practice and out-of-hours services during 2008/09 influenza season (week 1–9 2009) and pandemic influenza season (week 30–51 2009).
Figure 2
Figure 2. Proportion of ILI in out-of-hours services out of all ILI during 2008/09 influenza season (week 1–9 2009) and pandemic influenza (week 30–51 2009) season in Norway.
See this image and copyright information in PMC

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