Capacity and Adaptations of General Practice during an Influenza Pandemic

Simonsen, Kristian A; Hunskaar, Steinar; Sandvik, Hogne; Rørtveit, Guri

doi:10.1371/journal.pone.0069408

Cited by 22 publications

(23 citation statements)

References 14 publications

(14 reference statements)

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“…This concurs with the findings of a study on the influenza pandemic in 2009, in which the authors concluded that the general practitioner services were flexible, and could respond to increased need in the population (13).…”

Section: Gastrointestinal Complaintssupporting

confidence: 88%

Russefeiring og eksamenstid – bruk av fastlege og legevakt

et al. 2017

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Section: Gastrointestinal Complaintssupporting

confidence: 88%

Russefeiring og eksamenstid – bruk av fastlege og legevakt

et al. 2017

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“…Administration of antivirals without prescription during the pandemic may also have contributed to fewer people visiting a physician for treatment of influenza infection [ 28 ]. Probably those with more severe symptoms were more likely to seek healthcare [ 29 ], and our estimates are therefore likely to relate to more severe influenza infections. Infection severity or host response could be important, as influenza diagnosed in primary care did not show a clear association.…”

Section: Discussionmentioning

confidence: 99%

Pandemic influenza and subsequent risk of type 1 diabetes: a nationwide cohort study

et al. 2018

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Aims/hypothesisCase reports have linked influenza infections to the development of type 1 diabetes. We investigated whether pandemic and seasonal influenza infections were associated with subsequent increased risk of type 1 diabetes.MethodsIn this population-based registry study, we linked individual-level data from national health registries for the entire Norwegian population under the age of 30 years for the years 2006–2014 (2.5 million individuals). Data were obtained from the National Registry (population data), the Norwegian Patient Registry (data on inpatient and outpatient specialist care), the Primary Care Database, the Norwegian Prescription Database and the Norwegian Surveillance System for Communicable Diseases. Pandemic influenza was defined as either a clinical influenza diagnosis during the main pandemic period or a laboratory-confirmed test. Seasonal influenza was defined by a clinical diagnosis of influenza between 2006 and 2014. We used Cox regression to estimate HRs for new-onset type 1 diabetes after an influenza infection, adjusted for year of birth, sex, place of birth and education.ResultsThe adjusted HR for type 1 diabetes after pandemic influenza infection was 1.19 (95% CI 0.97, 1.46). In the subgroup with laboratory-confirmed influenza A (H1N1), influenza was associated with a twofold higher risk of subsequent type 1 diabetes before age 30 years (adjusted HR: 2.26, 95% CI 1.51, 3.38).Conclusions/interpretationOverall, we could not demonstrate a clear association between clinically reported pandemic influenza infection and incident type 1 diabetes. However, we found a twofold excess of incident diabetes in the subgroup with laboratory-confirmed pandemic influenza A (H1N1).Electronic supplementary materialThe online version of this article (10.1007/s00125-018-4662-7) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

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“…In 2009, the contact rate for respiratory infections was especially high, probably due to the swine influenza pandemic during that year, but the increase was equally distributed between the RGPs at daytime and OOH [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Point-of-care testing with CRP in primary care: a registry-based observational study from Norway

et al. 2015

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BackgroundNorwegian primary health care is maintained on the regular general practitioners (RGPs), GP’s contracted to the municipalities in a list patient system, working at daytime and at out-of-hours services (OOH services). Respiratory disease is most prevalent during OOH services, and in more than 50 % of the consultations, a CRP test is performed. Children in particular have a high consultation rate, and the CRP test is frequently conducted, but the contributing factors behind its frequent use are not known. This study compares the RGPs rate of CRP use at daytime and OOH in consultations with children and how this rate is influenced by characteristics of the RGPs.MethodsA cross-sectional register study was conducted based on all (N = 2 552 600) electronic compensation claims from consultations with children ≤ 5 year during the period 2009–2011 from primary health care. Consultation rates and CRP use were estimated and analysed using descriptive methods. Being among the 20 % of RGPs with the highest rate of CRP use at daytime or OOH was an outcome measure in regression analyses using RGP-, and RGP list characteristics as explanatory variables.ResultsOne third of all RGPs work regularly in OOH services, and they use CRP 1.42 times more frequently in consultations with children in OOH services than in daytime services even when the distribution of diagnosis according to ICPC-2 chapters is similar. Not being approved specialist, have a large number at their patient-lists but relatively few children on their list and a large number of consultations with children were significantly associated with frequent use of CRP in daytime services. The predictors for frequent CRP use in OOH services were being a young doctor, having many consultations with children during OOH and a frequent use of CRP in daytime services.ConclusionsThe increase in the frequency of CRP test use from daytime to OOH occurs in general for RGPs and for all most used diagnoses. The RGPs who use the CRP test most frequently in their daytime practice have the highest rate of CRP in OOH services.

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Capacity and Adaptations of General Practice during an Influenza Pandemic

Cited by 22 publications

References 14 publications

Russefeiring og eksamenstid – bruk av fastlege og legevakt

Russefeiring og eksamenstid – bruk av fastlege og legevakt

Pandemic influenza and subsequent risk of type 1 diabetes: a nationwide cohort study

Point-of-care testing with CRP in primary care: a registry-based observational study from Norway

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