Cancer patients’ use of primary care out-of-hours services: a cross-sectional study in Norway

OBJECTIVE: To investigate how cancer patients in Norway use primary care out-of-hours (OOH) services and describe different contact types and procedures. DESIGN: A retrospective cross-sectional registry study using a billing registry data source. SETTING: Norwegian primary care OOH services in 2014. SUBJECTS: All patients’ contacts in OOH services in 2014. Cancer patients were identified by ICPC-2 diagnosis. MAIN OUTCOME MEASURES: Frequency of cancer patients’ contacts with OOH services, contact types, diagnoses, procedures, and socio-demographic characteristics. RESULTS: In total, 5752 cancer patients had 20,220 contacts (1% of all) in OOH services. Half of the contacts were cancer related. Cancer in the digestive (22.9%) and respiratory (18.0%) systems were most frequent; and infection/fever (21.8%) and pain (13.6%) most frequent additional diagnoses. A total of 4170 patients had at least one cancer-related direct contact; of these, 64.5% had only one contact during the year. Cancer patients had more home visits and more physicians’ contact with municipal nursing services than other patients, but fewer consultations (p < 0.001). Patients in the least central municipalities had significantly more contacts than more central municipalities (p < 0.001). CONCLUSION: There was no indication of overuse of OOH services by cancer patients in Norway, which could indicate good quality of cancer care in general. KEY POINTS: Many are concerned about unnecessary use of emergency medical services for non-urgent conditions. • There was no indication of overuse of out-of-hours services by cancer patients in Norway. • Cancer patients had relatively more home visits, physician’s contact with the municipal nursing service, and weekend contacts than other patients. • Cancer patients in the least central municipalities had relatively more contacts with out-of-hours services than those in more central municipalities.