Differences in medical services in Nordic general practice: a comparative survey from the QUALICOPC study

Abstract

Objective: We aim to describe medical services provided by Nordic general practitioners (GPs), and to explore possible differences between the countries.

Design and setting: We did a comparative analysis of selected data from the Nordic part of the study Quality and Costs of Primary Care in Europe (QUALICOPC).

Subjects: A total of 875 Nordic GPs (198 Norwegian, 80 Icelandic, 97 Swedish, 212 Danish and 288 Finnish) answered identical questionnaires regarding their practices.

Main outcome measures: The GPs indicated which equipment they used in practice, which procedures that were carried out, and to what extent they were involved in treatment/follow-up of a selection of diagnoses.

Results: The Danish GPs performed minor surgical procedures significantly less frequent than GPs in all other countries, although they inserted IUDs significantly more often than GPs in Iceland, Sweden and Finland. Finnish GPs performed a majority of the medical procedures more frequently than GPs in the other countries. The GPs in Iceland reported involvement in a more narrow selection of conditions than the GPs in the other countries. The Finnish GPs had more advanced technical equipment than GPs in all other Nordic countries.

Conclusions: GPs in all Nordic countries are well equipped and offer a wide range of medical services, yet with a substantial variation between countries. There was no clear pattern of GPs in one country doing consistently more procedures, having consistently more equipment and treating a larger diversity of medical conditions than GPs in the other countries. However, structural factors seemed to affect the services offered.

Keyword:

• General practice
• Organisation and Administration
• health services
• Nordic countries
• diagnosis
• equipment
• procedures
• QUALICOPC

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Notice of duplicate publication: Differences in medical services in Nordic general practice: a comparative survey from the QUALICOPC study

Ethics

The QUALICOPC study was presented to the relevant ethic committees in the Nordic countries. The study was approved by the Danish Data Agency, the Ethical Committee of the Pirkanmaa Hospital District in Finland, the Regional Ethical Review Board of Linköping in Sweden (Dnr 2011/481-31; Dnr 2013/120-32) and the Icelandic National Bioethics Committee. The Regional Committee for Medical and Health Research Ethics in South-Eastern Norway concluded that their approval was not required for this study.

Acknowledgements

The authors are grateful to all the participating GPs of the QUALICOPC study in the Nordic countries. We also wish to thank the coordinating QUALICOPC Consortium members for their role throughout the study. PhD Ibrahimu Mdala at the University of Oslo provided valuable assistance in planning the statistical analyses.

Disclosure statement

The authors report no conflicts of interest.

Notes on contributors

Torunn Bjerve Eide is a GP specialist and PhD student at the Department of General Practice, Institute of Health and Society, at the University of Oslo, Norway.

Jørund Straand is a professor and Head of Department at the Department of General Practice, Institute of Health and Society, at the University of Oslo, Norway.

Cecilia Björkelund is a professor at the Department of Primary Health Care, Institute of Medicine, University of Gothenburg, Sweden.

Elise Kosunen is a professor at the Department of General Practice, University of Tampere, Finland.

Ofeigur Thorgeirsson is a GP at the Grafarvogur Primary Care Centre, Reykjavik, Iceland.

Peter Vedsted is a professor of Primary Care at the Research Unit for General Practice, and Professor of Innovative Patient Pathways at Silkeborg Diagnostic Centre, Aarhus University, Denmark.

Elin Olaug Rosvold is a professor at the Department of General Practice, Institute of Health and Society, at the University of Oslo, Norway, and Head of the Norwegian Research School in General Practice.

Additional information

Funding

The study was conducted as part of the European QUALICOPC project. QUALICOPC was co-funded by the European Commission Seventh Framework Program (FP7/2007–2013) under grant agreement 242141. TBE received funding from The Norwegian Committee on Research in General Practice and the Norwegian Research Fund for General Practice.