Changes in location and number of nurse consultations as the supply of general practitioners decreases in primary health care: six-year register-based follow-up cohort study in the city of Vantaa, Finland.

Objective: To investigate whether the location and the number of nurse consultations have changed in response to the continuously decreasing number of GP consultations in the fourth-largest city in Finland. It has been suggested that nurse consultations are replacing GP consultations. Design: A retr...

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Publicado en:Scandinavian Journal of Primary Health Care Vol. 42; no. 4; pp. 643 - 650
Autores principales: Enckell, Aina, Laine, Merja K., Roitto, Hanna-Maria, Raina, Marko, Kauppila, Timo
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Dec2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2024
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      pub: Taylor & Francis Ltd
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        10.1080/02813432.2024.2375548
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        atl: Changes in location and number of nurse consultations as the supply of general practitioners decreases in primary health care: six-year register-based follow-up cohort study in the city of Vantaa, Finland.
      aug:
        au:
          Enckell, Aina
          Laine, Merja K.
          Roitto, Hanna-Maria
          Raina, Marko
          Kauppila, Timo
        affil: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
      sug:
        subj:
          Referral and Consultation Trends
          Referral and Consultation Statistics and Numerical Data
          Practical Nurses
          Registered Nurses
          Physicians, Family Labor Supply
          Emergency Service
          Primary Health Care
          Human
          Finland
          Funding Source
          Prospective Studies
          Retrospective Design
          Record Review
          Descriptive Statistics
      ab: Objective: To investigate whether the location and the number of nurse consultations have changed in response to the continuously decreasing number of GP consultations in the fourth-largest city in Finland. It has been suggested that nurse consultations are replacing GP consultations. Design: A retrospective register-based follow-up cohort study. Setting: Public primary health care in the City of Vantaa, Finland. Subjects: All documented face-to-face office-hour consultations with practical and registered nurses, and consultations with practical and registered nurse in the emergency department of Vantaa primary health care between 1 January 2009 and 31 December, 2014. Main outcome measures: Change in the number of consultations with practical and registered nurses between 2009 and 2014 in primary health care both during office-hours and in the emergency department. Results: Over the follow-up period, the monthly median number of practical nurse consultations in the emergency department per 1000 inhabitants increased from 1.6 (interquartile range [IQR] 1.3–1.7) to 10.5 (10.3–12.2) (p < 0.001) and registered nurse consultations from a median of 3.6 (3.0–4.0) to 14.5 (13.0–16.6) (p < 0.001). However, there was no significant change in the median monthly number of office-hour consultations with practical or registered nurses. Conclusions: It appears that in primary health care, medical consultations have shifted from GPs to nurses with lower education levels, and from care during office-hours to emergency care. KEY POINTS: The number of general practitioner (GP) consultations are decreasing. Tasks are being transferred from GPs to nurses to improve access to care. The number of office-hour consultations with nurses did not change, despite the decrease in GP consultations. In the emergency department, the number of nurse consultations increased significantly when GP consultations decreased. Medical consultations seem to have shifted to the emergency department and the nurses.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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