ArticleBMJ open2013
Is a high level of general practitioner consultations associated with low outpatients specialist clinic use? A cross-sectional study.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Complements or substitutes? Associations between volumes of care provided in the community and hospitals.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Article
- Qualitative evaluation of the general practitioner chronic non-communicable diseases training programme.BMC medical education · 2020Article
- Differences in medical services in Nordic general practice: a comparative survey from the QUALICOPC study.Scandinavian journal of primary health care · 2017Article
Corrections and comments
- Erratum issuedCorrection.2013
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine if increased general practice activity is associated with lower outpatient specialist clinic use.
designCross-sectional population based study.
settingAll 430 Norwegian municipalities in 2009.
participantsAll Norwegians aged ≥65 years (n=721 915; 56% women-15% of the total population).
main outcome measureSpecialised care outpatient clinic consultations per 1000 inhabitants (OPC rate). Main explanatory: general practitioner (GP) consultations per 1000 inhabitants (GP rate).
resultsIn total, there were 3 339 031 GP consultations (57% women) and 1 757 864 OPC consultations (53% women). The national mean GP rate was 4625.2 GP consultations per 1000 inhabitants (SD 1234.3) and the national mean OPC rate was 2434.3 per 1000 inhabitants (SD 695.3). Crude analysis showed a statistically significant positive association between GP rates and OPC rates. In regression analyses, we identified three effect modifiers; age, mortality and the municipal composite variable of 'hospital status' (present/not present) and 'population size' (small, medium and large). We stratified manually by these effect modifiers into five strata. Crude stratified analyses showed a statistically significant positive association for three out of five strata. For the same three strata, those in the highest GP consultation rate quintile had higher mean OPC rates compared with those in the lowest quintile after adjustment for confounders (p<0.001). People aged ≥85 in small municipalities had approximately 30% lower specialist care use compared with their peers in larger municipalities, although the association between GP-rates and OPC-rates was still positive.
conclusionsIn a universal health insurance system with high GP-accessibility, a health policy focusing solely on a higher activity in terms of GP consultations will not likely decrease OPC use among elderly.
Identifiers
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Registered trials
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