[Organization of Norwegian out-of-hours primary health care services]. / Organisering av legevakt.

BACKGROUND: The organization of out-of-hours primary health care services in Norway is currently changing from municipal-based to larger inter-municipal co-operations with regular employees and improved competence. The Norwegian Medical Association and others have encouraged the establishment of larger out-of-hours primary health care units that include all municipalities and regular GPs and serve the entire population. More data are needed to study the situation for out-of-hours services in Norway. MATERIAL AND METHODS: The National Centre for Emergency Primary Health Care sent questionnaires to all 433 municipalities in Norway the autumn of 2005 to study how the out-of-hours primary health services are organized. RESULTS: Out-of-hours primary health services is an inter-municipality endeavour in two-thirds of Norwegian municipalities and one third of the remaining municipalities have plans to start such co-operation. Regular GPs participate in out-of-hours services to a varying degree. In half of the municipalities all regular GPs participate in out-of-hours duty. Participation decreases with increasing numbers of inhabitants and regular GPs in the municalities. We found a distinct variation in the number of phone calls per inhabitant to municipal out-of-hours services. Due to geographical factors, there are also variations in patient transport time and availability of ambulances to the out-of-hours offices. INTERPRETATION: We observed distinct variations in the organization of the out-of-hours emergency primary health services in Norway. Some of these differences are due to differences in population density and geographical factors.

[Locations, facilities and routines in Norwegian out-of-hours emergency primary health care services]. / Beliggenhet, lokaler og rutiner ved norske legevakter.

BACKGROUND: Limited data are available on casualty clinic facilities and localisation, inter-municipal co-operation and routines for out-of-hours services in the 433 Norwegian municipalities. The National centre for emergency primary health care collected data on these issues from October 2005 until February 2006. METHOD: Questionnaires concerning organisation of the out-of-hours services, casualty clinic facilities, locations and routines were sent to every Norwegian municipality. RESULTS: 282 of the 433 municipalities are in charge of out-of-hours services in 262 districts in the evenings and 230 districts during nights and weekends. There is inter-municipal cooperation in 100 of the districts. Most out-of-hours services are located in one casualty clinic in the host municipality and have the same locations as GP surgeries and laboratories. Most clinics offered the same services, but some routines were different. About half of the casualty clinics had a system for training of doctors and other health personnel. Half of the doctors on duty were available on the emergency communications system (radio). User assessments were collected, telephone calls documented and discrepancies reported to a varying degree, and medical histories were not consistently sent to regular GPs. INTERPRETATION: Inter-municipal co-operations are most common in areas with a high population density, i.e. in southern and eastern parts of Norway. Varying routines in out-of-hours service districts indicate that several municipalities do not fulfil all the obligations in regulations from the Ministry of health and care services in Norway.