Utilization of health care services in Norway

Equal access to health services for the entire population is a goal in Norway. However, the frequency of use and type of health services used by inhabitants varies. Several factors including place of residence, distance to health services, gender, age and level of educations may affect their utilization.

In Norway, patients need a referral from the general practitioner (GP) or doctors at out-of-hour services (OOH) in order to be admitted to hospitals. The number of patients these doctors refer to hospitals or other services varies greatly. Factors like doctor’s gender, age, seniority, level of education (specialist versus non- specialist), workload and distance to the hospital might explain these differences.

In this project, we are going to investigate different groups of patients admitted for emergency hospital stay, their admission and discharge diagnoses, and whether they contact either general practitioner or out-of-hours doctor prior to admission. We would also like to study admission rates among primary care doctors in order to reveal differences and factors particularly crucial for the utilization of health care services and referrals. In addition, we are going to measure continuity of care (CoC) in primary health care and its association with utilization of out-of-hour services and health outcomes. Continuity of care is described as having the same GP over a long time and is an important factor in utilization of health care services.

We will use data from several health registries. In order to do a comprehensive investigation, we need data from the whole population over several years. The information is going to be pseudo-anonymized before the researchers get access to data and it will not be possible to identify the participants.

Norwegian Data Protection Authority (DPA) has given permission to carry out the project and The Regional Committee for Medical and Health Research Ethics has given exemption from the obligation of confidentiality.

This project is a collaboration between Norwegian Center for Primary Health Care (NKLM) and the department of public health and primary care at the University of Bergen. NKLM provides the funding for the project. Steinar Hunskår is the project director and Jesper Blinkenberg is the daily manager. Hogne Sandvik, Øystein Hetlevik and Sahar Pahlavanyali are also project participants.