Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul 31;1(2):177-83.
doi: 10.4081/jphr.2012.e28. eCollection 2012 Jun 15.

The Ecology of Medical Care in Norway: Wide Use of General Practitioners may not Necessarily Keep Patients out of Hospitals

Affiliations

The Ecology of Medical Care in Norway: Wide Use of General Practitioners may not Necessarily Keep Patients out of Hospitals

Anne Helen Hansen et al. J Public Health Res. .

Abstract

Background: Our aim was to investigate the pattern of self reported symptoms and utilisation of health care services in Norway.

Design and methods: With data from the cross-sectional Tromsø Study (2007-8), we estimated population proportions reporting symptoms and use of seven different health services. By logistic regression we estimated differences according to age and gender.

Results: In this study 12,982 persons aged 30-87 years participated, constituting 65.7% of those invited. More than 900/1000 reported symptoms or health problems in a year as well as in a month, and 214/1000 and 816/1000 visited a general practitioner once or more in a month and a year, respectively. The corresponding figures were 91/1000 and 421/1000 for specialist outpatient visits, and 14/1000 and 116/1000 for hospitalisations. Physiotherapists were visited by 210/1000, chiropractors by 76/1000, complementary and alternative medical providers by 127/1000, and dentists by 692/1000 in a year. Women used most health care services more than men, but genders used hospitalisations and chiropractors equally. Utilisation of all services increased with age, except chiropractors, dentists and complementary and alternative medical providers.

Conclusions: Almost the entire population reported health related problems during the previous year, and most residents visited a general practitioner. Yet there were high rates of inpatient and outpatient specialist utilisation. We suggest that wide use of general practitioners may not necessarily keep patients out of specialist care and hospitals.

Acknowledgments: the authors would like to thank Tor Anvik for a significant contribution in developing the idea for the study, Tom Wilsgård for useful discussions about the statistical analyses and Jarl-Stian Olsen for graphic design of the figures. They would also thank the people of Tromsø and The Tromsø Study for giving data to this study. Northern Norway Regional Health Authority and The University of Tromsø funded this research.

Keywords: cross-sectional study; general practitioner; health care utilisation; hospitalisation; specialist.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: the authors declare no conflict of interests.

Figures

Figure 1.
Figure 1.
Monthly prevalence estimates of self-reported symptoms and illnesses, and use of different health care services for persons 30 years and over.
Figure 2.
Figure 2.
Annual prevalence estimates of self-reported symptoms and illnesses, and use of different health care services for persons 30 years and over.

References

    1. White KL, Williams TF, Greenberg BG.The ecology of medical care. N Engl J Med 1961;265:885-92 - PubMed
    1. Green LA, Fryer GE, Yawn B P, Lanier D, Dovey SM.The ecology of medical care revisited. N Engl J Med 2001;26:2021-25 - PubMed
    1. Dovey SM, Weitzman M, Fryer GE, et al. The ecology of medical care for children in the United States. Pediatrics 2003;111:1024-29 - PubMed
    1. Fryer GE, Green LA, Dovey SM, et al. Variation in the Ecology of Medical Care. Ann Fam Med 2003;2:81-9 - PMC - PubMed
    1. Leung GM, Wong IOL, Chan WS, et al. The ecology of health care in Hong Kong. Soc Sci Med 2005;61:577-90 - PubMed

LinkOut - more resources