Utilization of Norway’s Emergency Wards: The Second 5 Years after the Introduction of the Patient List System

Ursula Goth,Bjørgulf Claussen,Hugo Hammer

doi:10.3390/ijerph110303375

Abstract

Utilization of services is an important indicator for estimating access to healthcare. In Norway, the General Practitioner Scheme, a patient list system, was established in 2001 to enable a stable doctor-patient relationship. Although satisfaction with the system is generally high, people often choose a more accessible but inferior solution for routine care: emergency wards. The aim of the article is to investigate contact patterns in primary health care situations for the total population in urban and remote areas of Norway and for major immigrant groups in Oslo. The primary regression model had a cross-sectional study design analyzing 2,609,107 consultations in representative municipalities across Norway, estimating the probability of choosing the emergency ward in substitution to a general practitioner. In a second regression model comprising 625,590 consultations in Oslo, we calculated this likelihood for immigrants from the 14 largest groups. We noted substantial differences in emergency ward utilization between ethnic Norwegians both in rural and remote areas and among the various immigrant groups residing in Oslo. Oslo utilization of emergency ward services for the whole population declined, and so did this use among all immigrant groups after 2009. Other municipalities, while overwhelmingly ethnically Norwegian, showed diverse patterns including an increase in some and a decrease in others, results which we were unable to explain.

Highlights

Equity in health care might be understood as the absence of systematic health disparities in the population [1]
Outside GP office hours, emergency ward (EW) utilization ranged from 3% to 15%
Oslo had the highest frequency of contact with EWs, but outside of office hours, most municipalities had greater frequencies than Oslo

Summary

Introduction

Equity in health care might be understood as the absence of systematic health disparities in the population [1]. (GP Scheme) in 2001, a reform aiming at comprehensive stability and efficiency in the general practitioner–patient relationship, especially important for people suffering from recurring or complex medical problems. This patient list system is anchored at the municipal level, and entitles every resident to an assigned GP on a voluntary basis [2]. The concept of emergency primary care, offered out of office hours, is for patients to get access to immediate medical care and receive essential medical diagnostics and treatment for acute illness or injuries. The concept of emergency primary care, offered out of office hours, is for patients to get access to immediate medical care [3].

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