Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Out-of-hours demand in primary care : frequency, mode of contact and reasons for encounter in Switzerland
Authors: Huber, Carola A.
Rosemann, Thomas
Zoller, Marco
Eichler, Klaus
Senn, Oliver
DOI: 10.1111/j.1365-2753.2010.01418.x
Published in: Journal of Evaluation in Clinical Practice
Volume(Issue): 17
Issue: 1
Pages: 174
Pages to: 179
Issue Date: 2011
Publisher / Ed. Institution: Wiley
ISSN: 1356-1294
Language: English
Subjects: Adult; After-hours care; Emergency medical service; Female; General practitioner; Human; Male; Middle aged; Survey and questionnaire; Switzerland; Health service need and demand; Primary health care
Subject (DDC): 362: Health and social services
Abstract: Rationale, aims and objectives: To investigate the demand for traditional out-of-hours general practitioner (GP) emergency care in Switzerland including GPs’ satisfaction and reasons for encounter (RFE). Method: During a 2-month period (2009), a questionnaire-based, cross-sectional study was performed in GPs participating in the mandatory out-of-hours service in the city of Zurich, Switzerland. The number and mode of patient contacts were assessed to investigate the demand for GP care in traditional out-of-hours services. GPs and patient characteristics, including RFE according to the International Classification of Primary Care, were noted. Descriptive statistics and non-parametric tests were conducted. Results: Out of the 295 out-of-hours episodes during the study period, 148 (50%) duty periods were documented by a total of 93 GPs (75% men) with a mean (SD) age of 48.0 (6.2) years. The median (interquartile range) number of out-of-hours contacts was 5 (3–8) and the demand for home visits was significantly more common compared with practice and telephone consultations. A total of 112 different RFEs were responsible for the 382 documented patient contacts with fever accounting for the most common complaint (13.9%). Although 80% of GPs agreed to be satisfied overall with their profession as primary care provider, 57.6% among them were dissatisfied with the current out-of-hours service. Inappropriate payment and interference with their daily work in practice were most frequently reported. Conclusions: Our findings indicate that there is still strong patient demand for out-of-hours care with special need for home visits, suggesting that new organizational models such as integrating GPs into emergency care may not be an appropriate approach for all patients. Therefore, the ongoing reorganization of the out-of-hours-service in many health care systems has to be evaluated carefully in order not to miss important patient needs.
Fulltext version: Published version
License (according to publishing contract): Licence according to publishing contract
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Appears in collections:Publikationen School of Management and Law

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