Access to the NHS by telephone and Internet during an influenza pandemic: an observational study

作者：Rutter Paul^*; Mytton Oliver; Ellis Benjamin; Donaldson Liam

来源：BMJ Open, 2014, 4(2): e004174.

DOI：10.1136/bmjopen-2013-004174

• Public Health

Objectives To examine use of a novel telephone and Internet servicethe National Pandemic Flu Service (NPFS)by the population of England during the 2009-2010 influenza pandemic.
Setting National telephone and Internet-based service.
Participants Service available to population of England (n=51.8 million).
Primary and secondary outcome measures Primary: service use rate, by week. Numbers and age-specific and sex-specific rates of population who: accessed service; were authorised to collect antiviral medication; collected antiviral medication; were advised to seek further face-to-face assessment. Secondary: daily mean contacts by hour; proportion using service by telephone/Internet.
Results The NPFS was activated on 23 July 2009, operated for 204days and assessed 2.7 million patients (5200 consultations/100000 population). This was six times the number of people who consulted their general practitioner with influenza-like illness during the same period (823 consultations/100000 population, rate ratio (RR)=6.30, 95% CI 6.28 to 6.32). Women used the service more than men (52.6 vs 43.4 assessments/1000 population, RR1 21, 95% CI 1.21 to 1.22). Among adults, use of the service declined with age (16-29 years: 74.4 vs 65 years+: 9.9 assessments/1000 population (RR 7.46 95% CI 7.41 to 7.52). Almost three-quarters of those assessed met the criteria to receive antiviral medication (1807866/2488510; 72.6%). Most of the people subsequently collected this medication, although more than one-third did not (n=646709; 35.8%). Just over one-third of those assessed were advised to seek further face-to-face assessment with a practitioner (951332/2488504; 38.2%).
Conclusions This innovative healthcare service operated at large scale and achieved its aim of relieving considerable pressure from mainstream health services, while providing appropriate initial assessment and management for patients. This offers proof-of-concept for such a service that, with further refinement, England can use in future pandemics. Other countries may wish to adopt a similar system as part of their pandemic emergency planning.

• 出版日期2014