Hogne Sandvik1, Steinar Hunskår, Esperanza Diaz. 1. National Centre for Emergency Primary Health Care, Uni Health, Uni Research, Bergen, Norway. hogne.sandvik@isf.uib.no
Abstract
BACKGROUND: Norwegian emergency medical services are used with frequency, often in relation to conditions that could wait until the next day to be handled by the patient's regular GP (RGP). We investigated whether there are characteristics of particular GPs that may help explain why patients on their list use the emergency medical services. MATERIAL AND METHODS: We used data from the billing cards for 2008 from all emergency doctors, linked to information from the Regular GP database and Statistics Norway, for a total of 4,097 RGPs. For each RGP we estimated a contact rate: The total number of contacts reported for their list patients (identified by their personal ID numbers), divided by the length of the RGP's list. This rate was subsequently analysed with regard to characteristics of the RGP (bivariate analyses and multiple logistic regression). RESULTS: The average contact rate amounted to 27.4 contacts per 100 list patients, with significant variation between the RGPs (the 25th percentile was 17.8 contacts and the 75th percentile 33.1). Patients of male RGPs, young RGPs and immigrant RGPs used the emergency medical services more frequently than patients of female RGPs, older RGPs and Norwegian RGPs. Patients from long lists, single-doctor practices and open lists used the emergency medical services less frequently than patients from short lists, group practices and closed lists. The contact rate was higher in rural municipalities than in urban areas. INTERPRETATION: The large variations in the use of emergency medical services indicate that more RGPs should take measures to improve accessibility for emergency calls during the daytime.
BACKGROUND: Norwegian emergency medical services are used with frequency, often in relation to conditions that could wait until the next day to be handled by the patient's regular GP (RGP). We investigated whether there are characteristics of particular GPs that may help explain why patients on their list use the emergency medical services. MATERIAL AND METHODS: We used data from the billing cards for 2008 from all emergency doctors, linked to information from the Regular GP database and Statistics Norway, for a total of 4,097 RGPs. For each RGP we estimated a contact rate: The total number of contacts reported for their list patients (identified by their personal ID numbers), divided by the length of the RGP's list. This rate was subsequently analysed with regard to characteristics of the RGP (bivariate analyses and multiple logistic regression). RESULTS: The average contact rate amounted to 27.4 contacts per 100 list patients, with significant variation between the RGPs (the 25th percentile was 17.8 contacts and the 75th percentile 33.1). Patients of male RGPs, young RGPs and immigrant RGPs used the emergency medical services more frequently than patients of female RGPs, older RGPs and Norwegian RGPs. Patients from long lists, single-doctor practices and open lists used the emergency medical services less frequently than patients from short lists, group practices and closed lists. The contact rate was higher in rural municipalities than in urban areas. INTERPRETATION: The large variations in the use of emergency medical services indicate that more RGPs should take measures to improve accessibility for emergency calls during the daytime.