[Emergency service in Arendal--a new model of intermunicipal emergency service]

Over the past years there has been increasing debate over the organisation of off-hour primary care emergency services. In March 2000 we established an emergency room serving 80% of the total population of a Norwegian county, Aust-Agder. The most important change introduced was a reduction in house calls. Patients from smaller municipalities now have to come in to the emergency room; previously many consultations were made in the patients' own homes. This organisational model has now been evaluated to see if it made patients less satisfied and whether it was less expensive to run.

100 patients were interviewed by questionnaire in order to see if there were changes in their satisfaction with the emergency services provided. Costs were studied by collecting data from the social security service and from the participating municipalities before (1999) and after (2000) the reorganisation.

The overall impression is that patients have not expressed any dissatisfaction with the new organisational model and that it has cut expenses. We found that the social security service had cost savings of 31% for doctors on call, while the municipalities had an increase in expenditure of 17%.

It is possible to establish larger off-hour primary care emergency services without greater inconvenience to the patients. The new model is beneficial for doctors and saves costs for society, though the social security service's savings are somewhat offset by increased expenses on the part of the municipalities.