Impact of NHS Direct on general practice consultations during the winter of 1999-2000: analysis of routinely collected data

摘要

The impact of NHS Direct on other primary care services in the United Kingdom has been the subject of recent debate. A hospital bed crisis occurred in the winter of 1999-2000, but according to routine primary care surveillance systems the incidence of influenza-like illness did not reach epidemic proportions (as conventionally described). Considerable medical and media interest was given to influenza activity during this "millennium" winter. There was speculation that there was a genuine influenza epidemic but that people were telephoning NHS Direct and not seeking help from their general practitioner, resulting in an artificially low incidence of influenza-like illness. At the time there was partial coverage of England and Wales by NHS Direct; we therefore used this "natural experiment" to assess whether the introduction of NHS Direct had any impact on episodes of influenza-like illness and other cases of respiratory infections seen by general practitioners.