Background
Methods
Recruitment and data collection
Statistical analyses
Results
Characteristics | Responders | Non-responders | Population of GPs in Northern Norway | ||
---|---|---|---|---|---|
Male | Female | Total | Total | N=4762
| |
GP | GP | sample | |||
n=30 | n=14 | n=44 | n=60 | ||
Mean age, year | 45.2 | 44.6 | 45.13
| 50.33
| 45.0
4
|
Gender, % | 68.2 | 31.8 | 31.7% female | 36.3 % female
4
| |
Specialists in family medicine, % | 50.0 | 50.0 | 50.0 | 40.0 | 46.5
4
|
Private practice, % | 63.3 | 57.1 | 61.4 | 51.15
| 76.5
4
|
Mean number of GPs in practices | 4.5 | 4.2 | 4.4 | 3.6 | 3.8 |
Solo practice6, % | 10.0 | 14.3 | 11.4 | 8.3 | 11.1
4
|
Medical degree from Norway, % | 70.0 | 71.4 | 70.5 | 46.95
| 62.1
4
|
Mean list size, persons | 897 | 902 | 899 | 910 | 9617
|
Mean years with current list population (median) | 8.6 | 8.6 | 8.6 (5.5) | ||
Mean number of days per week in clinical practice | 3.9 | 3.8 | 3.8 | ||
Mean (median) municipality population in the GP’s workplace | 11683 | 26042 | 16257 | 10791 | 5291 |
(2209) | |||||
Mean travel time to nearest hospital, minutes | 89 | 70 | 83 | 95 |
Referral to secondary care and radiological examination
Referral to secondary care
#GPs | Mean referral rates per 100 consultations | (n / N) | Adjusted | 95% CI | ||
---|---|---|---|---|---|---|
odds ratio | ||||||
% (median) | ||||||
Total mean (median) referral rate | 13.7 (13.0) | (595/4350) | ||||
Range: 4.0 - 28.0 | ||||||
Variables | ||||||
Patients’ gender | Male, 0 | 13.0 | (248/1911) | |||
Female, 1 | 14.2 | (347/2439) | 1.05 | (0.88 - 1.27) | ||
Patients’ age | 0-9 years | 8.0 | (19/238) | 0.432
| (0.26 - 0.73) | |
10-29 years | 16.4 | (104/636) | 1 | |||
30-49 years | 15.4 | (180/1166) | 0.90 | (0.69 - 1.18) | ||
50-69 years | 13.3 | (176/1321) | 0.773
| (0.59 - 1.0009) | ||
>=70 years | 11.7 | (116/989) | 0.642
| (0.48 - 0.86) | ||
GPs’ gender | Male, 0 | 30 | 12.6 (12) | (376/2977) | ||
Female, 1 | 14 | 16.0 (13) | (219/1373) | 1.252
| (1.03 - 1.52) | |
GPs’ age | < 35 years | 12 | 13.0 (11) | (152/1174) | 0.702
| (0.55 - 0.91) |
35 – 49 years | 17 | 16.1 (15) | (270/1676) | 1 | ||
>= 50 years | 15 | 11.5 (12) | (173/1500) | 0.83 | (0.65 - 1.07) | |
Specialists in family medicine | No, 0 | 22 | 14.9 (15) | (321/2149) | ||
Yes, 1 | 22 | 12.5 (12) | (274/2201) | 0.762
| (0.60 - 0.96) | |
Solo practice | No, 0 | 39 | 13.3 (12) | (510/3850) | ||
Yes, 1 | 5 | 17.0 (15) | (85/500) | 1.30 | (0.98 - 1.71) | |
Practice type | Private practice, 0 | 27 | 12.1 (12) | (324/2675) | ||
Salaried, 1 | 17 | 16.2 (16) | (271/1675) | 1.362
| (1.11 - 1.66) | |
Travel time to nearest hospital | <30 minutes | 12 | 13.0 (12) | (156/1201) | 0.94 | (0.70 - 1.25) |
30 - 89 minutes | 12 | 16.7 (15) | (192/1148) | 1 | ||
>= 90 minutes | 20 | 12.3 (12) | (247/2001) | 0.804
| (0.64 - 1.02) | |
Country where medical degree was obtained | Abroad=0 | 13 | 14.8 (14) | (184/1247) | Not included in model | |
Norway=1 | 31 | 13.3 (12) | (411/3103) |
Referral to radiological examination
#GPs | Mean referral rates, | (n / N) | Adjusted | 95% CI | ||
---|---|---|---|---|---|---|
per 100 consultations | odds ratio | |||||
% (median) | ||||||
Total mean (median) referral rate | 4.2 (4.0) | (181/4350) | ||||
Range: 0.0-12.9 | ||||||
Patients’ gender | Male, 0 | 4.1 | (79/1911) | |||
Female, 1 | 4.2 | (102/2439) | 0.96 | (0.70 - 1.30) | ||
Patients’ age | 0-9 years | 2.1 | (5/238) | 0.402
| (0.16 - 1.02) | |
10-29 years | 3.0 | (19/636) | 0.563
| (0.33 - 0.95) | ||
30-49 years | 5.2 | (61/1166) | 1 | |||
50-69 years | 4.4 | (58/1321) | 0.83 | (0.57 - 1.20) | ||
>=70 years | 3.8 | (38/989) | 0.70 | (0.46- 1.07) | ||
GPs’ gender | Male, 0 | 30 | 4.0 (4.0) | (120/2977) | ||
Female, 1 | 14 | 4.4 (3.0) | (61/1373) | 0.98 | (0.61- 1.57) | |
GPs’ age | < 35 years | 12 | 2.9 (2.0) | (34/1174) | 0.96 | (0.49 - 1.86) |
35 – 49 years | 17 | 5.1 (4.1) | (86/1676) | 1 | ||
>= 50 years | 15 | 4.1 (3.0) | (61/1500) | 0.72 | (0.41- 1.26) | |
Specialists in family medicine | No, 0 | 22 | 3.2 (3.0) | (68/2149) | ||
Yes, 1 | 22 | 5.1 (4.0) | (113/2201) | 1.933
| (1.05 - 3.55) | |
Solo practice | No, 0 | 39 | 4.3 (4.0) | (164/3850) | Not included in model | |
Yes, 1 | 5 | 3.4 (4.0) | (17/500) | |||
Practice type | Private practice, 0 | 27 | 3.5 (2.0) | (94/2675) | ||
Salaried, 1 | 17 | 5.2 (5.0) | (87/1675) | 2.003
| (1.21 - 3.31) | |
Travel time to nearest hospital | <30 minutes | 12 | 4.4 (2.0) | (53/1201) | 0.99 | (0.52 - 1.86) |
30 - 89 minutes | 12 | 5.4 (5.0) | (62/1148) | 1 | ||
>= 90 minutes | 20 | 3.3 (3.0) | (66/2001) | 0.66 | (0.39 - 1.12) | |
Country where medical degree was obtained | Abroad=0 | 13 | 3.1 (3.0) | (39/1247) | ||
Norway=1 | 31 | 4.6 (4.0) | (142/3103) | 1.733
| (1.03 – 2.89) |
Introducing the issue of referral in the consultations and corresponding referral rates
GP | Lowest quartile, | Highest quartile, | All GPs | |||
---|---|---|---|---|---|---|
strata | referral rate | referral rate | ||||
<10% , | >=16%, | |||||
n = 1102 | n = 1047 | n = 4350 | ||||
consultations | consultations | consultations | ||||
n = 11 GPs | n = 11 GPs | n = 44 GPs | ||||
Referral | Referral | Referral | Referral | Referral | Referral | |
issue | rate | issue | rate | issue | rate | |
introduced | introduced | introduced | ||||
% | % | % | % | % | % | |
(95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | |
(n/N) | (n/N) | (n/N) | (n/N) | (n/N) | (n/N) | |
Referral rate, | ||||||
% | 7.8 | 20.9 | 13.7 | |||
(95% CI) | (6.2 – 9.4) | (18.5 –23.4) | (12.7–1 4.7) | |||
(n/N) | (86/1102) | (219/1047) | (595/4350) | |||
Referral | 18.0 | 43.4 | 31.3 | 66.8 | 23.0 | 59.4 |
issue | (15.7–20.2) | (36.5–50.4) | (28.5- 34.1) | (61.7–71.9) | (21.8 - 24.3) | (56.4 - 62.5) |
introduced | (198/1102) | (86/198) | (328/1047) | (219/328) | (1001/4350) | (595/1001) |
Referral | ||||||
issue of | 26.3 | 51.9 | 29.0 | 66.3 | 29.4 | 59.5 |
introduced | (20.3 - 33.0) | (38.1–65.7) | (24.1 - 34.2) | (56.7 –75.9) | (26.6 – 32.3) | (53.9 - 65.2) |
by patient | (52/198) | (27/52) | (95/328) | (63/95) | (294/1001) | (175/294) |
Referral | ||||||
issue | 73.7 | 40.4 | 71.0 | 67.0 | 70.6 | 59.4 |
introduced | (67.0 - 79.7) | (32.4–48.5) | (65.8 - 75.9) | (60.9 –73.4) | (67.8 - 73.5) | (55.8 - 63.0) |
by GP | (146/198) | (59/146) | (233/328) | (156/233) | (707/1001) | (420/707) |