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Impact of the COVID-19 pandemic on the National Telehealth Service for triage and referral in Sweden : a national retrospective observational study

Berg, Johanna LU orcid and Wretborn, Jens LU (2024) In BMJ Open 14(12).
Abstract

OBJECTIVES: Telehealth, the provision of healthcare through digital communication, has been proposed as a potential solution to meet the increasing demand for healthcare, particularly in the setting of the COVID-19 pandemic. Sweden has an established national telehealth service for triage and referral by phone (1177) since 2013 which has the potential to meet this increasing demand. However, little is known about the development and retention in demand during and after the pandemic in Sweden. The objective of this study was to investigate the utilisation of the national telehealth service in Sweden before, during and after the pandemic in relation to emergency department (ED) visits.

METHODS: This was a retrospective observational... (More)

OBJECTIVES: Telehealth, the provision of healthcare through digital communication, has been proposed as a potential solution to meet the increasing demand for healthcare, particularly in the setting of the COVID-19 pandemic. Sweden has an established national telehealth service for triage and referral by phone (1177) since 2013 which has the potential to meet this increasing demand. However, little is known about the development and retention in demand during and after the pandemic in Sweden. The objective of this study was to investigate the utilisation of the national telehealth service in Sweden before, during and after the pandemic in relation to emergency department (ED) visits.

METHODS: This was a retrospective observational study of telephone calls to the national telehealth service in Sweden. We collected the number of calls, number of answered calls and visits to ED in Sweden from 2017 through 2021, aggregated by month. The difference in number of calls and visits was analysed using Student's t-test for related samples.

RESULTS: Data were collected from all 21 healthcare regions in Sweden, serving 10.5 million citizens. The average number of monthly calls was 48 (SD 10) calls per 1000 citizens. The first month of the pandemic, March 2020, had the highest monthly calls per capita during the whole study period: 62 (diff 14, 95% CI 9 to 19, p<0.001). During the first 3 months of the pandemic, monthly calls increased by 22% (52.7 vs 43.2) compared with 2019 (diff 9.5, 95% CI -28 to -9, p=0.17). There was a 17% increase in calls for the whole year of 2020 compared with 2019 (49.2 vs 41.9, diff 7.3, 95% CI 3 to 11, p=0.002). Capacity, defined as the answer ratio, showed a negative correlation with demand (r=0.75, p<0.001).

CONCLUSION: The increase in calls to the national telehealth service during the first year of the COVID-19 pandemic suggests that the community will turn to a telehealth system in a healthcare crisis. The lack of capacity to meet the increasing demand may limit the effects of the telehealth service on the healthcare system as a whole.

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author
and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, COVID-19/epidemiology, Emergency Service, Hospital/statistics & numerical data, Pandemics, Referral and Consultation/statistics & numerical data, Retrospective Studies, Sweden/epidemiology, Telemedicine/statistics & numerical data, Triage
in
BMJ Open
volume
14
issue
12
article number
e091627
publisher
BMJ Publishing Group
external identifiers
  • pmid:39632112
  • scopus:85211688605
ISSN
2044-6055
DOI
10.1136/bmjopen-2024-091627
language
English
LU publication?
no
additional info
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
id
9ceac3a3-50e5-416e-a173-d7ba0d9c3da2
date added to LUP
2025-11-11 15:27:12
date last changed
2025-11-12 04:00:22
@article{9ceac3a3-50e5-416e-a173-d7ba0d9c3da2,
  abstract     = {{<p>OBJECTIVES: Telehealth, the provision of healthcare through digital communication, has been proposed as a potential solution to meet the increasing demand for healthcare, particularly in the setting of the COVID-19 pandemic. Sweden has an established national telehealth service for triage and referral by phone (1177) since 2013 which has the potential to meet this increasing demand. However, little is known about the development and retention in demand during and after the pandemic in Sweden. The objective of this study was to investigate the utilisation of the national telehealth service in Sweden before, during and after the pandemic in relation to emergency department (ED) visits.</p><p>METHODS: This was a retrospective observational study of telephone calls to the national telehealth service in Sweden. We collected the number of calls, number of answered calls and visits to ED in Sweden from 2017 through 2021, aggregated by month. The difference in number of calls and visits was analysed using Student's t-test for related samples.</p><p>RESULTS: Data were collected from all 21 healthcare regions in Sweden, serving 10.5 million citizens. The average number of monthly calls was 48 (SD 10) calls per 1000 citizens. The first month of the pandemic, March 2020, had the highest monthly calls per capita during the whole study period: 62 (diff 14, 95% CI 9 to 19, p&lt;0.001). During the first 3 months of the pandemic, monthly calls increased by 22% (52.7 vs 43.2) compared with 2019 (diff 9.5, 95% CI -28 to -9, p=0.17). There was a 17% increase in calls for the whole year of 2020 compared with 2019 (49.2 vs 41.9, diff 7.3, 95% CI 3 to 11, p=0.002). Capacity, defined as the answer ratio, showed a negative correlation with demand (r=0.75, p&lt;0.001).</p><p>CONCLUSION: The increase in calls to the national telehealth service during the first year of the COVID-19 pandemic suggests that the community will turn to a telehealth system in a healthcare crisis. The lack of capacity to meet the increasing demand may limit the effects of the telehealth service on the healthcare system as a whole.</p>}},
  author       = {{Berg, Johanna and Wretborn, Jens}},
  issn         = {{2044-6055}},
  keywords     = {{Humans; COVID-19/epidemiology; Emergency Service, Hospital/statistics & numerical data; Pandemics; Referral and Consultation/statistics & numerical data; Retrospective Studies; Sweden/epidemiology; Telemedicine/statistics & numerical data; Triage}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{12}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Impact of the COVID-19 pandemic on the National Telehealth Service for triage and referral in Sweden : a national retrospective observational study}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2024-091627}},
  doi          = {{10.1136/bmjopen-2024-091627}},
  volume       = {{14}},
  year         = {{2024}},
}