TY - JOUR
T1 - Health services use associated with emergency department closure
AU - Hansen, Kristian Schultz
AU - Enemark, Ulrika
AU - Foldspang, Anders
PY - 2011/7
Y1 - 2011/7
N2 - Objective: To study changes in health services consumption following substantial reduction in the availability of local emergency services in a small municipality population. Method: A dynamic cohort (21,000 residents of Viborg County, Denmark, of which 2,300 from Morsø municipality) was followed, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours, during a period of reduced opening hours and after closure, compared with the rest of Viborg County. Results: Emergency service use did not change among Morsø municipality residents compared to other Viborg County residents. Compared to men in other parts of the county, Morsø men did not change their use of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = 20.08, P 5 0.020), telephone consultations (β = 20.11, P = 0.007), home visits (β = 20.48, P = 0.009), and their inpatient hospital utilization (β = 20.12, P = 0.022) during the period when emergeny services were only available in the daytime. Conclusions: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care utilization patterns were observed among local residents that varied by gender.
AB - Objective: To study changes in health services consumption following substantial reduction in the availability of local emergency services in a small municipality population. Method: A dynamic cohort (21,000 residents of Viborg County, Denmark, of which 2,300 from Morsø municipality) was followed, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours, during a period of reduced opening hours and after closure, compared with the rest of Viborg County. Results: Emergency service use did not change among Morsø municipality residents compared to other Viborg County residents. Compared to men in other parts of the county, Morsø men did not change their use of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = 20.08, P 5 0.020), telephone consultations (β = 20.11, P = 0.007), home visits (β = 20.48, P = 0.009), and their inpatient hospital utilization (β = 20.12, P = 0.022) during the period when emergeny services were only available in the daytime. Conclusions: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care utilization patterns were observed among local residents that varied by gender.
KW - Cohort Studies
KW - Denmark
KW - Emergency Service, Hospital
KW - Female
KW - Health Services
KW - Health Services Accessibility
KW - Humans
KW - Male
KW - Sex Factors
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1258/jhsrp.2010.010100
DO - 10.1258/jhsrp.2010.010100
M3 - Journal article
C2 - 21389061
SN - 1355-8196
VL - 16
SP - 161
EP - 166
JO - Journal of Health Services Research & Policy
JF - Journal of Health Services Research & Policy
IS - 3
ER -