TY - JOUR T1 - Associations between primary healthcare and unplanned medical admissions in Norway: a multilevel analysis of the entire elderly population JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2013-004293 VL - 4 IS - 4 SP - e004293 AU - Trygve S Deraas AU - Gro R Berntsen AU - Andy P Jones AU - Olav H Førde AU - Erik R Sund Y1 - 2014/04/01 UR - http://bmjopen.bmj.com/content/4/4/e004293.abstract N2 - 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. Participants 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. Conclusions A higher primary healthcare volume was only associated with fewer UMAs among the oldest old in a universally accessible healthcare system. ER -