Associations between primary healthcare and unplanned medical admissions in Norway: a multilevel analysis of the entire elderly population.
BMJ Open
; 4(4): e004293, 2014 Apr 12.
Article
em En
| MEDLINE
| ID: mdl-24727427
ABSTRACT
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 OUTCOMEMEASURE:
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Hospitalização
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Noruega
País de publicação:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM