Raknes Guttorm, Morken Tone, Hunskår Steinar
Nasjonalt kompetansesenter for legevaktmedisin Uni Research Helse og RELIS Nord-Norge Universitetssykehuset Nord-Norge.
Nasjonalt kompetansesenter for legevaktmedisin Uni Research Helse og Institutt for global helse og samfunnsmedisin Universitetet i Bergen.
Tidsskr Nor Laegeforen. 2014 Nov 25;134(22):2145-50. doi: 10.4045/tidsskr.14.0437. eCollection 2014 Nov.
Geographical factors have an impact on the utilisation of out-of-hours services. In this study we have investigated the travel distance to out-of-hours casualty clinics in Norwegian municipalities in 2011 and the number of municipalities covered by the proposed recommendations for secondary on-call arrangements due to long distances.
We estimated the average maximum travel times and distances in Norwegian municipalities using a postcode-based method. Separate analyses were performed for municipalities with a single, permanently located casualty clinic. Altogether 417 out of 430 municipalities were included. We present the median value of the maximum travel times and distances for the included municipalities.
The median maximum average travel distance for the municipalities was 19 km. The median maximum average travel time was 22 minutes. In 40 of the municipalities (10 %) the median maximum average travel time exceeded 60 minutes, and in 97 municipalities (23 %) the median maximum average travel time exceeded 40 minutes. The population of these groups comprised 2 % and 5 % of the country's total population respectively. For municipalities with permanent emergency facilities(N = 316), the median average flight time 16 minutes and median average distance 13 km..
In many municipalities, the inhabitants have a long average journey to out-of-hours emergency health services, but seen as a whole, the inhabitants of these municipalities account for a very small proportion of the Norwegian population. The results indicate that the proposed recommendations for secondary on-call duty based on long distances apply to only a small number of inhabitants. The recommendations should therefore be adjusted and reformulated to become more relevant.
地理因素会影响非工作时间服务的使用情况。在本研究中,我们调查了2011年挪威各市镇居民前往非工作时间急诊诊所的出行距离,以及因距离较远而被提议的二级待命安排所覆盖的市镇数量。
我们采用基于邮政编码的方法估算了挪威各市镇的平均最长出行时间和距离。对设有单一常驻急诊诊所的市镇进行了单独分析。总共纳入了430个市镇中的417个。我们呈现了所纳入市镇最长出行时间和距离的中位数。
各市镇的最长平均出行距离中位数为19公里。最长平均出行时间中位数为22分钟。在40个市镇(10%)中,最长平均出行时间中位数超过60分钟,在97个市镇(23%)中,最长平均出行时间中位数超过40分钟。这些市镇的人口分别占该国总人口的2%和5%。对于设有永久性应急设施的市镇(N = 316),平均飞行时间中位数为16分钟,平均距离中位数为13公里。
在许多市镇,居民前往非工作时间紧急医疗服务的平均路程较长,但总体而言,这些市镇的居民在挪威人口中所占比例非常小。结果表明,基于远距离的提议二级待命值班建议仅适用于少数居民。因此,这些建议应进行调整和重新制定,以使其更具相关性。