Primary care doctors in acute call-outs to severe trauma incidents in Norway – associations with factors related to patients and doctors

Abstract

AbstractObjective Severe trauma patients need immediate prehospital intervention and transfer to a specialised trauma hospital. In Norway, primary care doctors (PCDs) are an integrated part of the prehospital trauma care. The aim of this study was to investigate the degree to which PCDs were involved in prehospital care of severe trauma patients and how factors related to patients and doctors were associated with call-outs to these incidents.Design This was a registry-based study in Norway on severe trauma patients with acute hospital admission during the period 2012–2018.Setting Data was obtained from three Norwegian official registries.Subjects By linking the registries, we studied the actions taken by the PCDs, whether they called out to severe trauma incidents.Main outcome measures In multivariable regression models, we investigated whether factors related to the PCDs (age, sex, specialisation in general practice (GP)) and patients (age, sex, duration of hospital stay, type of injury) were associated with call-outs.Results Out of 4342 severe trauma incidents, PCDs had documented involvement in 1683 (39%) and called out to 644 (15%). Increased proportions of PCD call-outs to severe trauma incidents were significantly associated with lower age of PCD, being a GP specialist, lower patient age, being a male patient, increased length of hospital stay and injuries to the head and the neck.Conclusions PCDs called out to a relatively low proportion of severe trauma patients. Several factors related to patients and doctors were associated with call-outs to severe trauma incidents in Norway.

Keywords

• Prehospital emergency care
• trauma care systems
• primary care doctor
• out-of-hours care
• casualty clinic
• Norway