What healthcare services do tourists use?

“I’m looking at this topic because of the huge increase in tourist numbers in Iceland. I was working in A&E myself, and I noticed we were seeing a lot more tourists. Some of them were in the right place, but others should have gone to the out-of-hours clinic. We lacked the resources to handle the situation. We need to find out why they are coming, what the most common issues are, why they are getting injured and what nursing care they require. I also wanted to look at the financial costs of improving preventative measures and protocols for determining where these people should go.”

Guðbjörg Pálsdóttir is the first nurse in Iceland to complete a Master’s degree in emergency nursing and to qualify as a specialist in emergency nursing. Guðbjörg has worked at the A&E unit in Fossvogur for around 20 years and is currently studying for a PhD in nursing at UI. She was also chair of the Icelandic Nurses’ Association until earlier this month. Her ground-breaking PhD thesis is the first in-depth research looking at the healthcare services accessed by tourists in Iceland. She has also co-supervised BS students writing theses in the same area.

More and more tourists but a lack of clear information

In 2014, Guðbjörg noticed that tourists were coming to A&E with all health-related problems. At that time, she worked in triage and saw many tourists who should not have been in the A&E unit. 

Many of these people paid significant bills for minor issues that could have been treated elsewhere. “We were seeing young tourists and backpackers sitting in the waiting room for five hours waiting for services they could have accessed at the out-of-hours clinic much cheaper and much more quickly,” says Guðbjörg.

She felt that this topic deserved further research. “People are always told to go to Fossvogur when they should be going somewhere else. A woman with a UTI could be treated at the out-of-hours clinic, or a young person with asthma who just needs a new inhaler. They come to this large A&E unit, spend most of the day waiting and pay much higher prices. This shouldn’t be happening, and that’s why I chose to research this topic,” explains Guðbjörg. 

Data will provide a clearer picture of accidents and resources

Guðbjörg’s thesis is based on Landspítali University Hospital data from 2010–2021, with a conscious decision to include the COVID-19 pandemic years. Originally she had planned to look at healthcare services for tourists across Iceland, but that proved unworkable since healthcare institutions in different areas use different data recording procedures. She revised the study to focus solely on data from South Iceland, which is also the region that sees the most tourists. 

The data includes information about nationality, primary symptoms, age and reasons for seeking medical assistance. Guðbjörg will also be conducting surveys among nursing staff working in A&E units across the country. “My focus is on nursing, the cost of services provided and how we can best distribute the funding required. At the same time, I want to create clearer information for tourists so that they know where to go to access the services they need, information which is readily available in other countries. Clearer information may reduce costs, and we may even be able to use the research data to help prevent the most common accidents or illnesses,” says Guðbjörg, emphasising that healthcare services should be under continuous reform. 

Research that could help a lot of people

“This is the first major study of its kind and will create valuable knowledge within the healthcare sector. It will provide us with an overview of the services that tourists use, the main medical issues they have in Iceland, and what kinds of accidents and illnesses they are experiencing. Are these common diseases or broken ankles, falls or car accidents, drowning incidents? How many people are dying? What age groups are we serving?” asks Guðbjörg. 

She emphasises that her findings will not only be valuable for the healthcare system but also for the tourist industry and authorities to help them understand the main medical problems that tourists experience and how they could be better informed. The results could also help the government make informed decisions about distributing state funding. 

Guðbjörg expects to publish her findings later this year.

Author of the article: Sesselja Malín Jónsdóttir, student in Journalism.