dc.contributor.author | Pahle, Andreas | |
dc.contributor.author | Sørli, Daniel | |
dc.contributor.author | Kristiansen, Ivar Sønbø | |
dc.contributor.author | Deraas, Trygve Sigvart | |
dc.contributor.author | Halvorsen, Peder Andreas | |
dc.date.accessioned | 2017-03-24T09:14:46Z | |
dc.date.available | 2017-03-24T09:14:46Z | |
dc.date.issued | 2017-01-21 | |
dc.description.abstract | Background: Studies of Primary Health Care (PHC) reveal considerable practice variations in terms of the range of
services provided. In Norway, general practitioners (GPs) are traditionally expected to perform IUD-insertions and
several surgical procedures as a part of comprehensive PHC. We aimed to investigate variation in the provision of
surgical procedures and IUD-insertions across GPs and over time and explore determinants of such variation.
Methods: Retrospective registry study of Norwegian GPs. From a comprehensive database of GPs’ reimbursement
claims, we obtained procedure codes and GP characteristics such as age, gender, list size and municipality
characteristics from 2006 through 2013. Multivariable logistic regression models were fitted to explore determinants
of practice variation.
Results: We extracted data from 4,828 GPs. In 2013, 91.0, 76.1 and 74.8% were reimbursed at least once for minor
and major surgical procedures and IUD-insertion, respectively. Female GPs had lower odds for performing major
surgical procedures (OR 0.38, 95% CI 0.32–0.45) and higher odds for performing IUD-insertions (OR 6.28, 95% CI 4.
47–8.82) than male GPs. Older GPs and GPs with shorter patient lists were less likely to perform surgical procedures.
GPs with longer patient lists had higher odds for performing IUD-insertions. The proportion of GPs performing
surgical procedures increased over time, while the proportion decreased for IUD-insertions. The number of
IUD-insertions in specialist care increased from 12,575 in 2011 to 15 216 (+21.0%) in 2014.
Conclusion: We observed a large variation in the provision of surgical procedures and IUD-insertions
amongst GPs in Norway. The GPs’ age, gender, list size and size of municipality were associated with
performing the procedures. Our findings suggest a shift of IUD-insertions from primary to specialist care. | en_US |
dc.description.sponsorship | There are no conflicts of interest. ASP and DS have received funding from the Norwegian Committee on Research in General Practice, a committee under the NCGP. The funding body had no role in design of the study and collection, analysis, and interpretation of data and in writing the manuscript. The others have done the research as a part of their scientific responsibilities
without any special funding. | en_US |
dc.description | Published version. Source at http://doi.org/10.1186/s12875-017-0581-9. License CC BY-NC-SA 4.0. | en_US |
dc.identifier.citation | Pahle A, Sørli D, Kristiansen IS, Deraas TS, Halvorsen PA. Practice variation in surgical procedures and IUD-insertions among general practitioners in Norway – a longitudinal
study . BMC Family Practice. 2017;18 | en_US |
dc.identifier.cristinID | FRIDAID 1450677 | |
dc.identifier.doi | 10.1186/s12875-017-0581-9 | |
dc.identifier.issn | 1471-2296 | |
dc.identifier.uri | https://hdl.handle.net/10037/10866 | |
dc.language.iso | eng | en_US |
dc.publisher | BioMed Central | en_US |
dc.relation.journal | BMC Family Practice | |
dc.rights.accessRights | openAccess | en_US |
dc.subject | VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Allmennmedisin: 751 | en_US |
dc.subject | VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Family practice: 751 | en_US |
dc.subject | General practitioner | en_US |
dc.subject | Primary health care | en_US |
dc.subject | Surgical procedures | en_US |
dc.subject | IUD-insertions | en_US |
dc.subject | Practice variation | en_US |
dc.subject | Comprehensiveness | en_US |
dc.title | Practice variation in surgical procedures and IUD-insertions among general practitioners in Norway – a longitudinal study | en_US |
dc.type | Journal article | en_US |
dc.type | Tidsskriftartikkel | en_US |
dc.type | Peer reviewed | en_US |