Use of Primary Care Emergency Services in Norway: Impact of Birth Country and Duration of Residence

Abstract

Abstract:Objective: In Norway, the General Practitioner Scheme was established in 2001. Satisfaction with the system is generally high. However, people often choose to visit community-based emergency wards (EW) for routine care instead. The aim of this paper is to describe which factors influence the choice of seeking care at the EW. Design, setting, and patients: Prior national research on utilization patterns has been based mostly on surveys showing a low response rate. By using merged register data, we analyzed the choice of the EW as a care provider in Oslo (Norway) for 2006 and 2007. Applying 1,934,248 observations of 279,531 different individuals, we estimated the probability of choosing the emergency ward for the Norwegian-born population as well as for the14-largest immigrant groups. Substantial variation between groups was identified. Main outcome: The proportion of EW visits was highest among patients from Somalia (11.7 percent) while the lowest proportion of EW users was among immigrants from Germany and Vietnam (5.3 percent). The results vary substantially within individual migrant groups; gender, age, and the duration of residence each influence the probability of visiting an EW. Conclusions: We found large differences in the probability of using an EW between individuals from immigrant populations, presumably because of barriers in access to primary care. Continuity in the physician-patient relationship is an important policy goal. A suggestion for policy is thus to improve communication about the organization of the Norwegian health-care sector to newly arrived immigrants, as well as to patients at the EW.

Immigrants’ use of primary health care services for mental health problems

“…Regarding all health problems, differences between immigrants’ and natives’ use of emergency primary health care (EPC) have been documented, though service use among immigrants varies by factors such as age, country background, immigration reason, length of stay and socioeconomic status [ 2 , 6 – 9 ]. A recent, national-level Norwegian study found that contact rates at EPC services were lower for immigrants as a whole compared with Norwegians, though higher among specific groups [ 3 ].…”

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

“…Oslo (the capital of Norway), as well as Bergen and Drammen, have the highest density of immigrants. Scandinavian research indicates a diverging picture regarding utilization of EW services by immigrants compared to non-migrants [ 8 , 9 , 10 , 11 ]. A Norwegian study concluded that high rates of EW use among immigrants are related to inadequate access to GP services, suggesting that new residents are not well informed about the organizational structure of the primary health sector [ 11 ].…”

“…A Norwegian study concluded that high rates of EW use among immigrants are related to inadequate access to GP services, suggesting that new residents are not well informed about the organizational structure of the primary health sector [ 11 ]. Another study has demonstrated that immigrants use the EW more often than non-migrants, and that the differences in EW use among immigrant groups are smaller than the differences between genders in these groups, confirming that the duration of residence influences the likelihood of visiting the EW and that this impact is greatest during the first years after arrival [ 8 ].…”

Assimilation effects on infant mortality among immigrants in Norway: Does maternal source country matter?

“…Such factors can include consanguinity, (Stoltenberg et al 1998), nutrition (Essen et al 2000b), and the utilisation of health care services (Goth and Godager 2012;Grytten, Skau, and Sørensen 2013). At least in the short run, women from countries with good access to health care services might be expected to be more frequent users of these services in the host country.…”

“…At least in the short run, women from countries with good access to health care services might be expected to be more frequent users of these services in the host country. Indeed, two studies have shown that women's utilisation of health care services varies by the source country (Goth and Godager 2012;Grytten, Skau, and Sørensen 2013).…”