Health services use associated with emergency department closure

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 -