title: Associations between primary healthcare and unplanned medical admissions in Norway: a multilevel analysis of the entire elderly population.
abstract: OBJECTIVE
  To examine if individual risk of unplanned medical admissions (UMAs) was associated with municipality general practitioner (GP) or long-term care (LTC) volume among the entire Norwegian elderly population.
  
  
  METHODS
  Cross-sectional population-based study.
  
  
  METHODS
  428 of 430 Norwegian municipalities in 2009.
  
  
  METHODS
  All Norwegians aged ≥65 years (n=721 915; 56% women-15% of the total population).
  
  
  METHODS
  Individual risk of UMA.
  
  
  RESULTS
  Using a multilevel analytical framework, consisting of individuals (N=722 464) nested within municipalities (N=428), nested within local hospital areas (N=52) we found no association between municipality GP or LTC volume and UMAs. However, we found that higher LTC levels of provision were associated with fewer hospitalisations among the older age groups. A modest geographical variability was observed for UMA in adjusted analysis.
  
  
  CONCLUSIONS
  A higher primary healthcare volume was only associated with fewer UMAs among the oldest old in a universally accessible healthcare system.
authors.affiliation: Center of Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Box 6, N-9038 Tromsø, Norway.
authors.forename: Trygve S
authors.initials: TS
authors.lastname: Deraas
authors.forename: Gro R
authors.initials: GR
authors.lastname: Berntsen
authors.forename: Andy P
authors.initials: AP
authors.lastname: Jones
authors.forename: Olav H
authors.initials: OH
authors.lastname: Førde
authors.forename: Erik R
authors.initials: ER
authors.lastname: Sund
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D009664:Norway / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors
keywords: Long-term Care; Primary Care; Small Area Analyses; Unplanned Admissions
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