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

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.

Bayesian Computing with INLA: A Review

“…The generality of R-INLA comes with a prize of complexity for the user, hence a simplified interface for a restricted set of models can be useful to improve accessibility for a specific target audience or provide additional tools that are mainly relevant for these models. Examples of such projects, are AnimalINLA (Holand et al, 2013), ShrinkBayes (Van De Wiel et al, 2013a,b, 2014Riebler et al, 2014), meta4diag , BAPC (Riebler and Held, 2016), diseasemapping and geostatp (Brown, 2015), and Bivand et al (2015). Similarly, the excursions package for calculating joint exceedance probabilities in GMRFs Lindgren, 2015, 2016) includes an interface to analyse LGMs estimated by R-INLA.…”

“…Recent examples of applications using the R-INLA package for statistical analysis, include disease mapping (Schrödle and Held, 2011b,a;Ugarte et al, 2014Ugarte et al, , 2016Papoila et al, 2014;Goicoa et al, 2016;, age-period-cohort models (Riebler and Held, 2016), evolution of the Ebola virus (Santermans et al, 2016), studies of relationship between access to housing, health and well-being in cities (Kandt et al, 2016), study of the prevalence and correlates of intimate partner violence against men in Africa (Tsiko, 2015), search for evidence of gene expression heterosis (Niemi et al, 2015), analysis of traffic pollution and hospital admissions in London (Halonen et al, 2016), early transcriptome changes in maize primary root tissues in response to moderate water deficit conditions by RNA-Sequencing (Opitz et al, 2016), performance of inbred and hybrid genotypes in plant breeding and genetics (Lithio and Nettleton, 2015), a study of Norwegian emergency wards (Goth et al, 2014), effects of measurement errors (Kröger et al, 2016;Muff and Keller, 2015), network meta-analysis (Sauter and Held, 2015), time-series analysis of genotyped human campylobacteriosis cases from the Manawatu region of New Zealand (Friedrich et al, 2016), modeling of parrotfish habitats (Roos et al, 2015b), Bayesian outbreak detection (Salmon et al, 2015), studies of long-term trends in the number of Monarch butterflies (Crewe and Mccracken, 2015), long-term effects on hospital admission and mortality of road traffic noise (Halonen et al, 2015), spatio-temporal dynamics of brain tumours (Iulian et al, 2015), ovarian cancer mortality (García-Pérez et al, 2015), the effect of preferential sampling on phylodynamic inference (Karcher et al, 2016), analysis of the impact of climate change on abundance trends in central Europe (Bowler et al, 2015), investigation of drinking patterns in US Counties from 2002 to 2012 …”

Bruk av sykehus og spesialisthelsetjenester blant innbyggere med norsk og utenlandsk bakgrunn

“…En studie viste at arbeidsinnvandrere hadde lave kontaktrater, mens flyktninger kunne ha relativt hyppige legebesøk (Diaz et al, 2014a). Andre studier har tatt for seg bruken av legevakt (Berg, 2009;Goth et al, 2014;Sandvik et al, 2012). Noen innvandrergrupper ser ut til å besøke legevakt relativt ofte, men de samme pasientene kan også ha forholdsvis mange besøk hos fastlegen (Diaz et al, 2014a).…”

“…Imidlertid finnes det betydelig mer materiale i Norge om bruken av primaerhelsetjenester blant innvandrere, og dessuten en del om bruken av legevaktstjenester. Også her er bildet sammensatt (Lunde og Texmon, 2013; Diaz et al, 2015a;Diaz et al, 2014a;Diaz og Kumar, 2014;Sandvik et al, 2012;Goth et al, 2014;Straiton et al, 2014). Generelt, når en ser alle innvandrere og alle aldersgrupper under ett, er innvandrernes bruksnivå av primaerhelsetjenester lavere enn bruksnivået blant dem uten innvandrerbakgrunn, men det er mange typer variasjoner, og enkelte innvandrergrupper har relativt hyppig bruk av primaerlegetjenester.…”

Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China

“…The National Health Service system can affect patient satisfaction 17,18. However, as the direct provider of medical service, hospitals have the ability to promote patient satisfaction by improving the quality of medical services on their side 19–23.…”