Hvilke fastleger deltar i legevakt?

Abstract

Approximately half of all accident and emergency medical (A&E) services are provided by regular general practitioners (RGPs). We wished to find out which RGPs staff the A&E services. The material comprises billing cards from all A&E doctors in 2008, linked to information from Statistics Norway and the Regular GP database. We estimated the proportion of various RGPs who staff the A&E roster and how many patient contacts they had while on duty. The same variables describing the RGPs were used in a multivariate logistic regression analysis, in which the dependent variable was whether the RGPs were on the emergency service roster or not. Altogether 53% of the RGPs were on the emergency service roster, and accounted for 47% of all patient contacts. The RGPs were older than other emergency doctors (44 years as opposed to 34 years), and included a smaller proportion of women (33% as opposed to 44%). Immigrants accounted for 23% of the RGPs and 21% of the other emergency doctors. Women RGPs were on A&E duty less frequently than their male counterparts in all age groups, and they also had fewer patient contacts (206 and 374). The participation rate decreased in proportion to the doctors' age, increasing list length and increasing centrality. Immigrant RGPs with a short time of residence in Norway had the highest frequency of on-call duty (81%). The number of women RGPs is increasing, and it is therefore likely that the frequency of on-call duty among RGPs will decrease further. However, the immigrants are providing a significant contribution to maintaining the A&E scheme.