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

Scand J Prim Health Care. 2001 Jun;19(2):95-8. doi: 10.1080/028134301750235303.

Abstract

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.

MeSH terms

  • Appointments and Schedules
  • Denmark
  • Emergency Service, Hospital / statistics & numerical data*
  • Family Practice / organization & administration*
  • Health Care Reform*
  • Health Services Accessibility / organization & administration*
  • Holidays
  • Humans
  • Night Care / organization & administration
  • Night Care / statistics & numerical data
  • Referral and Consultation
  • Triage / organization & administration*