Use of locums in the Regular GP Scheme 2016-22. / Vikarlegebruk i fastlegeordningen 2016­22.

Background: Under the Regular GP Scheme, locum GPs must be used when GPs are absent or when a patient list has no GP. We have studied the prevalence and development of locum contracts registered in the Regular GP Scheme in the period from 1 January 2016 to 31 December 2022. Material and methods: In this descriptive registry study, we categorised 21 418 locum contracts from the period 1 January 2016 to 31 December 2022 according to municipality and duration. We divided the municipalities into groups according to Statistics Norway's six centrality classes. Classes 1‒2 are central; 3‒4 are less central; and 5‒6 are the least central municipalities. The analysis is based on frequency tables, contingency tables and rates. Results: In the period studied, the number of registered locum contracts increased in Norway from 916 to 5003 (446 %). The increase was largest in centrality group 5‒6. The average duration of the locum positions was 195 days in centrality groups 1‒2 (95 % confidence interval (CI) 190‒200), 130 days in centrality groups 3‒4 (95 % CI 127‒134) and 67 days in centrality groups 5‒6 (95 % CI 64‒69). Centrality groups 5‒6 had twice as many locum contracts for full-time positions compared to centrality groups 1‒2, where part-time positions were more common. Locum contracts per list without a GP increased nationally from 0.5 to 4.7 in the study period. Interpretation: The GP Registry provides increasingly useful, nationwide information on the use of locum GPs. Use of locums in the Regular GP Scheme has increased significantly since 2016, and this may represent a challenge to equal access to health services. Future research should examine the causes and consequences of increased use of locum GPs.