DO GENERAL-PRACTITIONER HOSPITALS REDUCE THE UTILIZATION OF GENERAL-HOSPITAL BEDS EVIDENCE FROM FINNMARK COUNTY IN NORTH NORWAY

Study objective-To assess whether populations with access to general p ractitioner hospitals (GP hospitals) utilise general hospitals less th an populations without such access. Design-Observational study compari ng the total rates of admissions and of occupied bed days in general h ospitals between populations with and without access to GP hospitals. Comparisons were also made separately for diagnoses commonly encounter ed in GP hospitals. Setting-Two general hospitals serving the populati on of Finnmark county in north Norway Patients-35335 admissions based on five years' routine recordings from the two hospitals. Main results -The total rate of admission to general hospitals was lower in periphe ral municipalities with a GP hospital than in central municipalities w ithout this kind of institution, 26% and 28% lower for men and women r espectively. The corresponding differences were 38% and 52%, when anal ysed for occupied bed days. The differences were most pronounced fdr p atients with respiratory diseases, cardiac failure, and cancer who are primarily or intermediately treated or cared for in GP hospitals, and for patients with stroke and fractures, who are regularly transferred from general hospitals to GP hospitals for longer term follow up care . Conclusion-GP hospitals seem to reduce the utilisation of general ho spitals with respect to admissions as well as occupied bed days.