挪威两个大型非工作时间紧急初级保健区远程单元的实施情况。

Implementation of remote units in two large out-of-hours emergency primary care districts in Norway.

作者信息

Zakariassen Erik, Hunskaar Steinar

机构信息

National Centre for Emergency Primary Health Care, NORCE, Norwegian Research Centre, Bergen, Norway.

Group for Health Services Research, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

出版信息

Scand J Prim Health Care. 2025 Sep;43(3):538-545. doi: 10.1080/02813432.2025.2470470. Epub 2025 Feb 28.

Abstract

OBJECTIVE

An inter-municipal out-of-hours (OOH) district covers several municipalities with one centralized casualty clinic. These OOH districts are large geographical areas with long driving times to the casualty clinic. Remote OOH units were established in two OOH districts in Norway, to secure better access to the OOH service. Patients were offered video consultations with nurse-led appointments at the remote OOH units. The aim was to investigate contact rates and distribution of consultation types before and after the remote units were established. Design. An observational study with pre- and post-data collected from municipalities with and without (controls) remote OOH units.

SETTING

Two OOH districts, Førde and Molde, with five and four remote OOH units, respectively.

SUBJECTS

Inhabitants contacting the Local Emergency Communications Centers (LEMCs) in the two areas.

RESULTS

In municipalities that established remote OOH units the contact rates to the LEMCs decreased by 15% in Førde and 16% in the Molde OOH districts in 2021, compared with 2019. Control municipalities had an increased rate of 7% and 2%, respectively. Consultation rates decreased by 16% and 12% in municipalities with remote OOH units in Førde and Molde, respectively. In 2021, 7% of contacts from municipalities with remote OOH units in Førde OOH district and 3% in Molde OOH district ended in a consultation at a remote OOH unit. In the Molde OOH district, where the traditional casualty clinic was replaced with remote OOH units, home visits and callouts decreased by 76% and 86% from 2019 to 2021.

CONCLUSION

Establishing remote OOH units could have decreased contact and consultation rates in both districts. Most contacts were handled with actions other than a remote OOH unit encounter with video consultation. There was a large reduction of home visits and callouts in the Molde OOH district in 2021, compared with 2019.

摘要

目的

市际非工作时间(OOH)区域覆盖多个市镇,设有一个集中的急诊诊所。这些OOH区域地域广阔,前往急诊诊所的驾车时间较长。挪威在两个OOH区域设立了远程OOH单元,以确保更好地获得OOH服务。患者可在远程OOH单元预约由护士主导的视频会诊。目的是调查远程单元设立前后的联系率和会诊类型分布。设计:一项观察性研究,从设有和未设(对照)远程OOH单元的市镇收集前后数据。

设置

两个OOH区域,分别为福尔德和莫尔德,各有5个和4个远程OOH单元。

研究对象

两个地区与当地紧急通信中心(LEMC)联系的居民。

结果

与2019年相比,2021年在设立了远程OOH单元的市镇中,福尔德OOH区域与LEMC的联系率下降了15%,莫尔德OOH区域下降了16%。对照市镇的联系率分别上升了7%和2%。福尔德和莫尔德设有远程OOH单元的市镇的会诊率分别下降了16%和12%。2021年,福尔德OOH区域设有远程OOH单元的市镇有7%的联系以及莫尔德OOH区域有3%的联系最终在远程OOH单元进行了会诊。在莫尔德OOH区域,传统急诊诊所被远程OOH单元取代,从2019年到2021年,家访和出诊分别减少了76%和86%。

结论

设立远程OOH单元可能降低了两个区域的联系率和会诊率。大多数联系通过远程OOH单元视频会诊以外的方式处理。与2019年相比,2021年莫尔德OOH区域的家访和出诊大幅减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b0e/12377154/791687a069cb/IPRI_A_2470470_F0002_B.jpg

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