Health Services Utilisation Patterns Associated with Emergency Department Closure

Presenter: Anders Foldspang, Aarhus University, Denmark

Abstract

Aim – The aim was to study the impact of a substantial reduction in access to local emergency services, in terms of subsequent changes in health services consumption in a small municipality population.
Material – Based on Danish administrative registries, a dynamic cohort (a 10% open population sample, on the average about 21,000 residents of Viborg County, Denmark, including residents from Morsø Municipality (2,300 sample members)) was followed through 1997-2003. Data included information on individual sample members’ health services consumption, including emergency services utilisation and other hospital contact, contact to general practitioners, and socio-economic background.
Design – Two quasi-experimental design perspectives were combined: (1) A before-and-after perspective comparing health services consumption by the Morsø population samples before (1997-1999), during (2002-2002) and after (2003) the Morsø Hospital emergency room reduction in opening hours and staffing and eventual closure. (2) A contemporary perspective following in parallel the development of health services consumption by (a) the population samples of Morsø Municipality and (b) the rest of the Viborg County population samples.
Results – When taking into account developments in health services utilisation by Viborg County residents, emergency service utilisation did not change specifically among Morsø Municipality residents. Moreover, as compared to males in other parts of the county Morsø males did not change their utilisation of substitute health services. Contrasting this, Morsø females decreased their GP service and hospital utilisation.
Conclusions – Emergency services at neighbouring hospitals at maximum 40 Km away have partly been able to compensate for the decreased local emergency service provision. Concurrent changes in health care utilisation patterns were observed among local residents, varying among the two genders and involving changes in primary health services consumption.