Associations between primary healthcare and unplanned medical admissions in Norway: A multilevel analysis of the entire elderly population
Deraas, Trygve sigvart; Berntsen, Gro Karine Rosvold; Jones, Andy; Førde, Olav Helge; Sund, Erik Reidar
Journal article, Peer reviewed
Permanent lenke
http://hdl.handle.net/11250/284090Utgivelsesdato
2014Metadata
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Sammendrag
Objective: To examine if individual risk of unplanned
medical admissions (UMAs) was associated with
municipality general practitioner (GP) or long-term care
(LTC) volume among the entire Norwegian elderly
population.
Design: Cross-sectional population-based study.
Setting: 428 of 430 Norwegian municipalities in 2009.
Partic ipants: All Norwegians aged ≥65 years
(n=721 915; 56% women—15% of the total
population).
Main outcome measure: Individual risk of UMA.
Results: Using a multilevel analytical framework,
consisting of individuals (N=722 464) nested within
municipalities (N=428), nested within local hospital
areas (N=52) we found no association between
municipality GP or LTC volume and UMAs. However,
we found that higher LTC levels of provision were
associated with fewer hospitalisations among the older
age groups. A modest geographical variability was
observed for UMA in adjusted analysis.
Conclus ions: A higher primary healthcare volume was
only associated with fewer UMAs among the oldest old
in a universally accessible healthcare system.