ArticleBMC family practice2007
Out-of-hours demand for GP care and emergency services: patients' choices and referrals by general practitioners and ambulance services.
Article in BMC family practice, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2017Pooled it
- Why do patients with 'primary care sensitive' problems access ambulance services? A systematic mapping review of the literature.BMJ open · 2015Pooled it
- Reducing inappropriate accident and emergency department attendances: a systematic review of primary care service interventions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Pooled it
- The effectiveness of nurse practitioners working at a GP cooperative: a study protocol.BMC family practice · 2012Trial
- Barriers facing family physician in primary health care when dealing with emergency cases in Riyadh, Saudi Arabia.Journal of family medicine and primary care · 2022Review
- Pre- and post-home visit behaviors after using after-hours house call (AHHC) medical services: a questionnaire-based survey in Tokyo, Japan.BMC emergency medicine · 2021Article
- Types of Primary Healthcare Emergencies in Muscat, Oman: A retrospective cross-sectional study of five primary care centres.Sultan Qaboos University medical journal · 2021Article
- Patient motives for contacting out-of-hours care in Denmark: a cross-sectional study.BMC emergency medicine · 2020Observational
- Acute care pathways for patients calling the out-of-hours services.BMC health services research · 2020Observational
- Article
- Sociodemographic Characteristics Associated with Contacts to Emergency Medical Services and Out-of-Hours Primary Care: An Observational Study of 2.3 Million Citizens.Clinical epidemiology · 2020Article
- Preschool children in Danish out-of-hours primary care: a one-year descriptive study of face-to-face consultations.BMC family practice · 2019Article
- Do employees benefit from collaborations between out of hours general practitioners and emergency departments?BMC health services research · 2018Article
- Does X-ray imaging by GPC at emergency care access points in the Netherlands change patient flow and reduce ED crowding? A cohort study.Health science reports · 2018Article
- Patient and care characteristics of self-referrals treated by the general practitioner cooperative at emergency-care-access-points in the Netherlands.BMC family practice · 2017Article
- Medical appropriateness of adult calls to Danish out-of-hours primary care: a questionnaire-based survey.BMC family practice · 2017Article
- General practitioners' experiences with out-of-hours cardiorespiratory consultations: a qualitative study.BMJ open · 2016Article
- Barriers Facing Primary Health Care Physicians When Dealing with Emergency Cases in Jeddah, Saudi Arabia.Global journal of health science · 2016Article
- Impact of a well-developed primary care system on the length of stay in emergency departments in the Netherlands: a multicenter study.BMC health services research · 2016Observational
- Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOver the last five years, Dutch provision of out-of-hours primary health care has shifted from practice-based services towards large-scale general practitioner (GP) cooperatives. Only few population-based studies have been performed to assess the out-of-hours demand for GP and emergency care, including the referral patterns to the Accident and Emergency Department (AED) by GPs and ambulance services.
methodDuring two four-month periods (five-year interval), a prospective cross-sectional study was performed for a Dutch population of 62,000 people. Data were collected on all patient contacts with one GP cooperative and three AEDs bordering the region.
resultsOverall, GPs handled 88% of all out-of-hours contacts (275/1000 inhabitants/year), while the AED dealt with the remaining 12% of contacts (38/1000 inhabitants/year). Within the AED, the self-referrals represented a substantial number of contacts (43%), although within the total out-of-hours demand they only represented 5% of all contacts. Self-referrals were predominantly young adult males presenting with an injury, nineteen percent of whom had a fracture. Compared to self-referrals, patients who were referred by the GP or brought in by the ambulance services were generally older and were more frequently admitted for both injury and non-injury (p < 0.01 for all differences).
conclusionThe GP cooperative deals with the large majority of out-of-hours problems presented. Within the total demand, self-referrals constitute a stable, yet small group of patients, many of whom seem to have made a reasonable choice to attend the AED. The GPs and the ambulance services appear to be effectively selecting the problems that are presented to the AED.
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