[Equipment for diagnostics, laboratory analyses and treatment in out-of-hours services].

BACKGROUND

Availability of equipment for diagnostics and treatment in out-of-hours services in Norway is not documented and no guidelines exist on requirements for the various types of equipment (including drugs) needed. A knowledge basis on status and needs should be established so minimum requirements can be developed.

MATERIAL AND METHODS

The National Centre for Emergency Primary Health Care sent a questionnaire on availability of diagnostic equipment, laboratory tests, medication and quality assurance systems to all 261 municipal out-of-hours services in Norway in February 2006.

RESULTS

223/261 (86 %) of the services responded. 150 used the same office as a day-time practice, 59 had their own office and 14 were localised in a hospital/ emergency care unit. Services located in GP surgeries with a daytime-practice had a wider range of equipment, laboratory tests and medicines. Physicians on duty in the out-of-hours services with shared facilities did much of the laboratory work, but the quality control was done by the personnel at daytime. 27 % of the independent services did not have external control of their laboratory work (they were not members of the Norwegian Quality Improvement of Primary Care Laboratories). GPs were trained on acute medical situations more than once a year in 52 % of all the out-of-hours-services, but for only 40 % in the independent services. Other personnel were trained more than once a year in 74 % of the independent services.

INTERPRETATION

Availability of equipment and laboratory test repertoire for GPs on duty at out-of-hours services seems to depend on whether the services are shared with GP surgeries and also used at daytime, and the distance to ambulance, hospital and pharmacy. Lack of routines for laboratory work and low training frequency in acute medical procedures may lead to poor quality of the analyses and lower competence than needed.