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Research

GP decisions to participate in emergencies: a randomised vignette study

Magnus Hjortdahl, Dorte Gyrd-Hansen and Peder A Halvorsen
BJGP Open 2021; 5 (1): bjgpopen20X101153. DOI: https://doi.org/10.3399/bjgpopen20X101153
Magnus Hjortdahl
1 Department of Community Medicine, UiT The Arctic University of Norway Faculty of Health Sciences, Tromsø, Norway
MD, PhD
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  • For correspondence: magnus.hjortdahl{at}uit.no
Dorte Gyrd-Hansen
2 Department of Public Health, University of Southern Denmark, Odense, Denmark
MSc, PhD
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Peder A Halvorsen
1 Department of Community Medicine, UiT The Arctic University of Norway Faculty of Health Sciences, Tromsø, Norway
MD, PhD
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Article Figures & Data

Tables

    • View popup
    Table 1. Vignette groups
    Vignette groupCombination of cause, distance, and crowding
    1Trauma condition, short distance, no crowding
    2Trauma condition, short distance, crowding
    3Trauma condition, long distance, no crowding
    4Trauma condition, long distance, crowding
    5Medical condition, short distance, no crowding
    6Medical condition, short distance, crowding
    7Medical condition, long distance, no crowding
    8Medical condition, long distance, crowding
    • View popup
    Table 2. Characteristics of responders in the eight vignette groups
    Vignette groupMean age, yearsFemale, n (%)Mean number ofpatients on GP listSpecialist in generalpractice, n (%)Rural (>1 hour’s drive to nearest hospital), n (%)
    1 (n = 113)4449/112 (44)102466/113 (58)24/108 (22)
    2 (n = 136)4570/135 (52)103471/136 (52)39/131 (30)
    3 (n = 125)4561/125 (49)107078/125 (62)28/119 (24)
    4 (n = 109)4442/106 (40)101162/107 (58)23/103 (22)
    5 (n = 127)4560/125 (48)103879/125 (63)28/122 (23)
    6 (n = 118)4553/116 (46)103867/116 (58)35/114 (31)
    7 (n = 132)4544/129 (34)107372/130 (55)31/127 (24)
    8 (n = 142)4557/140 (41)105373/140 (52)39/141 (28)
    Respondersn = 100245436/988 (44)1043568/992 (57)247/965 (26)
    All GPs in Norway in 2016(n = 4644)a 4842%112855%19%
    • a Statistics Norway (SSB).

    • View popup
    Table 3. Vignettes ranked in order of participation rates (from high to low)
    Vignette group(combination of condition, distance, and crowding)GPs participating on callout in the vignette, n (%)Missing, n
    Trauma, short distance, crowding115/132 (87%)4
    Trauma, short distance, no crowding98/113 (87%)0
    Medical condition, short distance, no crowding105/123 (85%)4
    Trauma, long distance, no crowding101/125 (81%)0
    Trauma, long distance, crowding80/107 (75%)2
    Medical condition, long distance, no crowding92/129 (71%)3
    Medical condition, long distance, crowding84/139 (60%)3
    Medical condition, short distance, crowding70/118 (59%)0
    Total745/986 (76%)16
    • Difference between scenarios: χ2 60.8, degrees of freedom (DF) 7, P<0.05.

    • View popup
    Table 4. Participation rate related to condition, distance, and crowding
    VariablesProportion of GPs participating on the callout in the vignette, n (%)χ2 value/DFP value
    Trauma condition394/477 (83%)24.8/1<0.001
    Medical condition351/509 (69%)
    Short distance388/486 (80%)9.5/10.002
    Long distance357/500 (71%)
    No crowding396/490 (81%)14.6/1<0.001
    Crowding349/496 (70%)
    All745/986 (76%)
    • DF = degrees of freedom.

    • View popup
    Table 5. Multivariable logistic regression analyses: associations between GPs participating on callout in vignettes and OOH clinic characteristics
    GPs participating on callout in vignette, n (%)OR crude (95 % CI)OR adjusted (95% CI)
    C o-located ambulance 694/925 (75%)
    YesNo277/357 (78%)417/568 (73%)0.80 (0.59 to 1.09)Ref 0.88 (0.63 to 1.23) Ref
    Dedicated response vehicle 703/937 (75%)
    Yes, with driverYes, without driverNo138/167 (83%)123/163 (76%)442/607 (73%)1.78 (1.15 to 2.75)a1.15 (0.77 to 1.71)Ref 2.06 (1.25 to 3.41)a 0.92 (0.60 to 1.42) Ref
    Distance to hospital 715/953 (75%)
    More than 60 minutesLess than 60 minutes200/244 (82%)515/709 (73%)1.71 (1.19 to 2.47)aRef 1.47 (0.97 to 2.23) Ref
    Team training 730/968 (75%)
    Never or not relevantLess than annuallyAnnuallySeveral times a year300/436 (69%)196/257 (76%)167/200 (84%)67/75 (89%)Ref1.46 (1.03 to 2.07)a2.29 (1.50 to 3.51)a3.80 (1.77 to 8.12)a  Ref 1.44 (0.98 to 2.11) 1.78 (1.12 to 2.82)a 3.78 (1.64 to 8.68)a
    • Also adjusted for sex, age, specialist status, and OOH clinic location (large city: Oslo, Bergen, Stavanger, or Trondheim; single municipality or inter municipality).

    • a P<0.05.

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GP decisions to participate in emergencies: a randomised vignette study
Magnus Hjortdahl, Dorte Gyrd-Hansen, Peder A Halvorsen
BJGP Open 2021; 5 (1): bjgpopen20X101153. DOI: 10.3399/bjgpopen20X101153

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GP decisions to participate in emergencies: a randomised vignette study
Magnus Hjortdahl, Dorte Gyrd-Hansen, Peder A Halvorsen
BJGP Open 2021; 5 (1): bjgpopen20X101153. DOI: 10.3399/bjgpopen20X101153
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Keywords

  • primary health care
  • general practice
  • prehospital care
  • emergencies

More in this TOC Section

  • The role of reflexivity in exploring exclusion in GP training: a qualitative study of GP educators
  • Has the new Scottish GP contract improved GPs’ working lives in deprived areas? A secondary analysis of two cross-sectional national surveys of GPs’ views in 2018 and 2023
  • Challenges in reducing the 10-item CARE Measure to a two-item version: comparison of patients’ preferences with psychometric evaluation in a cross-sectional survey in Scotland
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