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Peter Vedsted

The effect of an out-of-hours reform on attendance at casualty wards. The Danish example

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OBJECTIVE: A reorganisation of the out-of-hours general practice service in Denmark was launched in January 1992. The biggest changes were in a mandatory telephone triage staffed by GPs and the replacement of small rota systems with county-based health centres. We aimed to analyse the effect of this out-of-hours reform on the number of contacts with the casualty wards. DESIGN: A register-based ecologic time-trend study of the mean number of annual contacts per inhabitant from 1988 to 1997. SETTING: The County of Aarhus. SUBJECTS: All 630000 inhabitants in the county. MAIN OUTCOME MEASURES: Mean number of annual contacts with casualty wards per inhabitant. Intercepts derived from two regression models. RESULTS: The mean number of contacts with casualty wards rose significantly during the whole period. Given this constant increase in contact rates, a regression model showed that the increase in the attendance rate with casualty wards after the reform was statistically insignificant. CONCLUSIONS: The decrease in the total number of contacts with the out-of-hours primary health care after the reform was not met by a corresponding increase in casualty ward contacts. A clear-cut significant increase in the use of casualty wards following the out-of-hours reform could not be demonstrated.
OriginalsprogEngelsk
TidsskriftScan J Primary Health Care
Vol/bind19
Nummer2
Sider (fra-til)95-98
StatusUdgivet - 2001

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