Relationship between use of increased primary health care and other out-patient care in a Swedish urban area. II. Utilisation of out-patient hospital services.

The expansion of the primary care services and its effect on utilization of the out-patient services in hospitals by the public have been analysed by a number of authors. Evaluation of the links vary: some studies state that an expansion of primary care goes together with an increase or an unchanged utilization of hospital visits - out-patient clinics, while others say that a decrease occurs. The present study analyses this problem in Stockholm city. This study has a longitudinal design and it covers a study district and a control district. The results support the hypothesis that the expansion of primary care in the study area results in a significant decrease in hospital visits in this area. The decrease occurred in most age groups among men as well as women, regardless of the type of visit (emergency or by appointment); it also occurred in the usual speciality areas in the general practitioner's everyday work.