Activity in out-of-hours services in Norway, 2007 16th Nordic Congress of General Practice May 2009,...
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Transcript of Activity in out-of-hours services in Norway, 2007 16th Nordic Congress of General Practice May 2009,...
Activity in out-of-hours services in Norway, 2007
16th Nordic Congress of General Practice
May 2009, Copenhagen
Elisabeth Holm Hansen, Erik Zakariassen, Steinar Hunskår
Norway has a two-level public health care system LEVEL 1
Municipalities • Primary Health care• Emergency medical services
24 hours a day• Casualty clinics with or without
nurses• LEMC
LEVEL 2Regional Health Authorities • Hospital• EMCC /113 • Ambulance services• National Air ambulance
Background
• In Norway, no valid activity statistics from the primary health care out-of-hours services
• The National Centre for Emergency Primary Health Care has initiated a project called The Watchtowers
• Aim: Provide information to enable monitoring, evaluation and comparison of activities in primary health care emergency services
Material and methods
• Day and night recording during one year of all requests to seven casualty clinics covering a total of 18 municipalities
• Variables: Time, gender, age, mode of contact, priority grade and first response initiated
Results
• During 2007 a total of 85 288 requests were registered, 399 contacts per 1000 inhabitants
• Estimated mean number of requests to Norwegian Casualty Clinics per inhabitant per year: 0,4
• 55 % women• Mean age 35 years
Contacts according to population (%)
0
5
10
15
20
25
30
35
40
45
0-4 year 5-14year 15-29 30-59 60-79 80 +
Population
Contacts
Mode of contact (%)
Telephone from patient or patients family 65 %
Direct attendance 26 %
Health personnel 6 %
National emergency medical communication centres (EMCC)
2 %
Police etc 1%
Priority degree (%)
0
10
20
30
40
50
60
70
80
90
Non- urgent Urgent Acute
Per
cen
t
Responses for all contacts Per cent Rate per 1000 inhabitants
Appointment with a doctor 63 251
Advice by telephone, doctor 10 38
Handled by nurse 24 96
Call-out of doctor and ambulance 1,7 7
Home visits by doctor 1,6 6
Total 100
Validation of contact registrations
• Reimbursement claims for 2006:
1.3 mill consultations by doctor in out-of-hours work
392 contacts per 1000 inhabitants
• Estimated national figures in our project 2007;
1,2 mill consultations by doctor in out-of-hours work
399 contacts per 1000 inhabitants
Interpretations
• Norway has a high rate of contacts to the out-of-hours services compared to other countries
• Norway has a large share of non-urgent cases
• Mode of contact influences action taken
• Valid national figures and future research of these services are important both for local services and policy makers