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Ph.d. om ulikheter mellom nordiske land i allmennlegetjenester

Cand.med Torunn Bjerve Eide, Institutt for helse og samfunn, Oslo, forsvarte 29.11.19 doktoravhandlingen “General practitioners´ and patients´ experiences and expectations. A comparative study from Norwegian and Nordic general practice; The Quality and Costs of Primary Care in Europe (QUALICOPC) study.”

Engelsk sammendrag

General practitioners´ and patients´ experiences and expectations. A cross-sectional study from Norwegian and Nordic general practice.

Comprehensive primary care services are associated with better healthcare quality. The aims of this thesis were to compare medical services provided by GPs in the Nordic countries, to study associations between organisational factors and Norwegian patients´ experiences in GP consultations, and to explore possible differences between GPs´ and patients´ expectations regarding the GPs´ services in Norway. The thesis is based on questionnaire data from 875 GPs from Norway, Denmark, Sweden, Finland and Iceland as well as questionnaire data from 1529 Norwegian patients.

GPs in the Nordic countries provided a wide spectrum of medical services. The Finnish GPs more frequently than their Nordic colleagues had access to advanced technological equipment like ultrasound and gastroscopes. Ninety per cent of Norwegian and 86% of Danish GPs inserted intra-uterine devices, and were significantly more likely to do this procedure than GPs in the other Nordic countries (Sweden 20%, Finland 70%, Iceland 13%). Icelandic GPs were less likely than Norwegian GPs to be involved in follow-up of patients with a selection of medical conditions, including rheumatoid arthritis, myocardial infarction, and Parkinson´s disease.

Patients visiting GPs with a short (≤900) or long patient lists (> 1300) were less likely than patients visiting GPs with medium sized patient list (900 – 1300) to report positive experiences with the communication with the GP. Norwegian GPs overestimated to what degree their patients would see them for a variety of common medical problems, e.g. deteriorating vision, anxiety, and sexual problems.

Differences in the medical services offered by Nordic GPs may be related to variations in remuneration systems and differences in task distribution. From the patients´ point of view, a medium sized patient list is preferable to allow for a more positive communicative experience. A further discussion on which tasks that should form part of general practice is warranted.