[Activities performed by general practitioners before and after the introduction of an inter-municipal emergency service and the list patient system].
BACKGROUND
Over a span of four years we studied the number and type of patient contacts with the off-hour emergency service in a municipality in Western Norway. At the start of the period, the service was organised by each municipality, later more municipalities formed a regional service. At the end of the period, a list patient system was introduced.


METHODS
All contacts from patients as well as activities performed by general practitioners on off-hour emergency duty were registered in four separate periods, from 1999 to 2002.


RESULTS
Simultaneously with shift from a local to a regional system, the proportion of home calls fell from 18% to less than 1%. The implementation of a list patient system combined with a regional system reduced the total number of contacts by 30%. Public expenditure was reduced by 66%.


CONCLUSIONS
The combination of a regional off-hour service and a list patient system gives an efficient organisation. The total work-load for doctors is significantly reduced and the quality of medical services improve; financial considerations also support a shift in off-hour emergency service towards regional organisation.
Jøsendal
Ola
O
Radøy legesenter, 5936 Manger. ola.josendal@psyhp.uib.no
Aase
Solfrid
S
D039602:After-Hours Care / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D017046:Cost Savings; D017598:Efficiency, Organizational; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D005194:Family Practice / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D018166:Health Care Reform / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D006792:House Calls / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D009664:Norway; D012017:Referral and Consultation / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D012042:Registries