title: Reasons for attending a general emergency outpatient clinic versus a regular general practitioner - a survey among immigrant and native walk-in patients in Oslo, Norway.
abstract: OBJECTIVE
  To explore reasons for attending a general emergency outpatient clinic versus a regular general practitioner (RGP).
  
  
  METHODS
  Cross-sectional study using a multilingual anonymous questionnaire.
  
  
  METHODS
  Native and immigrant walk-in patients attending a general emergency outpatient clinic in Oslo (Monday-Friday, 08:00-23:00) during 2 weeks in September 2009.
  
  
  METHODS
  We included 1022 walk-in patients: 565 native Norwegians (55%) and 457 immigrants (45%).
  
  
  METHODS
  Patients' reasons for attending an emergency outpatient clinic versus their RGP.
  
  
  RESULTS
  Among patients reporting an RGP affiliation, 49% tried to contact their RGP before this emergency encounter: 44% of native Norwegian and 58% of immigrant respondents. Immigrants from Africa [odds ratio (OR) = 2.55 (95% confidence interval [CI]: 1.46-4.46)] and Asia [OR = 2.32 (95% CI: 1.42-3.78)] were more likely to contact their RGP before attending the general emergency outpatient clinic compared with native Norwegians. The most frequent reason for attending the emergency clinic was difficulty making an immediate appointment with their RGP. A frequent reason for not contacting an RGP was lack of access: 21% of the native Norwegians versus 4% of the immigrants claimed their RGP was in another district/municipality, and 31% of the immigrants reported a lack of affiliation with the RGP scheme.
  
  
  CONCLUSIONS
  Access to primary care provided by an RGP affects patients' use of emergency health care services. To facilitate continuity of health care, policymakers should emphasize initiatives to improve access to primary health care services. KEY POINTS Access to immediate primary health care provided by a regular general practitioner (RGP) can reduce patients' use of emergency health care services. The main reason for attending a general emergency outpatient clinic was difficulty obtaining an immediate appointment with an RGP. A frequent reason for native Norwegians attending a general emergency outpatient clinic during the daytime is having an RGP outside Oslo. Lack of affiliation with the RGP scheme is a frequent reason for attending a general emergency outpatient clinic among immigrants.
authors.affiliation: a Department of General Practice , Institute of Health and Society, University of Oslo , Oslo , Norway.|b Department of Emergency General Practice , City of Oslo Health Agency , Oslo , Norway.
authors.forename: Sven Eirik
authors.initials: SE
authors.lastname: Ruud
authors.affiliation: a Department of General Practice , Institute of Health and Society, University of Oslo , Oslo , Norway.
authors.forename: Per
authors.initials: P
authors.lastname: Hjortdahl
authors.affiliation: a Department of General Practice , Institute of Health and Society, University of Oslo , Oslo , Norway.
authors.forename: Bård
authors.initials: B
authors.lastname: Natvig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants; D005260:Female; D058005:General Practitioners; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009664:Norway; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Norway; Primary health care; continuity of patient care; emergency medical services; emigrants and immigrants; general practice; general practitioner; patient acceptance of health care