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Poor quality in the emergency medical services - Document no. 3:9 (2005-2006)

In three out of five health regions over half the ambulance staff do not have a professional qualification. Patients can risk waiting for long periods at emergency departments before they receive any treatment. The Office of the Auditor General (OAG) also raises the question of whether sufficient attention is paid in all districts to the cost-efficient operation of the ambulance service.
Published 6/28/2006 9:39 AM

These are some of the conclusions given in Document no. 3:9 (2005–2006) The Office of the Auditor General’s investigation of emergency medical preparedness in the specialist health service that was submitted to the Storting on 28 June 2006.

The objective of the investigation was to shed light on whether the general public has satisfactory and equal access to emergency medical assistance through the emergency medical communication centres, the ambulance services, and the hospital emergency departments. The investigation has included a review of how the resources are managed, organised and utilised.

Operating expenses for ambulance services amounted to NOK 2.3 billion in 2004, varying from 2.6 to 7.1 per cent of the regional health authorities’ total operating expenses. The investigation questions whether sufficient attention is paid in all districts to the cost-efficient operation of the ambulance service.

The investigation shows that in the 14 emergency medical services districts examined a total of 60 per cent of those who telephone to request emergency assistance receive help within 12 minutes. However, there are variations in response time both between and within the different districts, and in some districts there was room for improvement in the response time.

In the country as a whole, 44 per cent of ambulance staff did not have a professional qualification in 2004. The Standing Committee for Social Affairs has emphasised that it is vital to set professional requirements for staff – particularly in areas that are far from a hospital. Nevertheless, the proportion of those without the appropriate qualification is highest in the Northern Norway regional Health Authority (73 per cent). In some emergency situations the relevant communication and dispatch centres and the ambulance services have difficulty in making contact with the duty doctor in the municipalities.

In cases where patients are driven to a hospital for further attention, they can risk waiting for long periods in the emergency department before they receive any treatment. In general it is the junior doctor who first examines the patients. Efficiency in Accident and Emergency (A & E) departments can be improved if there are more experienced doctors on the staff. To avoid unnecessary waiting and the formation of queues in emergency departments it is also important to reduce the proportion of so-called corridor patients in hospitals and to ensure that bottlenecks do not occur in the throughput of patients.

The investigation reveals that little information is reported regarding results attained in emergency medical services. The OAG therefore questions whether the ministry has the necessary management information on an area of such importance where help can save lives and where long distances must often be covered.

The document in Norwegian can be downloaded from this website or ordered from Akademika booksellers, tel. +47 22 18 81 00.

The provision concerning delayed public access to documents that are compiled by or sent to the Office of the Auditor General in connection with Document no. 3:9 has been repealed, cf. Section 18, paragraph 2 of the Auditor General Act.

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