ArticleBMJ open2020
What do we know about demand, use and outcomes in primary care out-of-hours services? A systematic scoping review of international literature.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Profile of European frequent attenders in primary health care: a systematic review and meta-analysis.Family practice · 2025Pooled it
- Task shifting from general practitioners to other health professionals in out-of-hours primary care - a systematic literature review on content and quality of task shifting.The European journal of general practice · 2024Pooled it
- Conjoint analyses of patients' preferences for primary care: a systematic review.BMC primary care · 2022Pooled it
- Telehealth and access to acute primary care in Europe: Balancing opportunity and equity.The European journal of general practice · 2026Article
- Telephone triage in urgent unscheduled primary care in 16 European countries: a cross-national questionnaire-based expert study.Scandinavian journal of primary health care · 2026Article
- Out-of-hours services in Zealand, Denmark. Consequences of changeover from GP-cooperative to integrated deputized services. A retrospective cohort study.Scandinavian journal of primary health care · 2026Article
- Task shifting from general practitioners to nurses and the association with patient flow and resource use in out-of-hours primary care clinics: a descriptive register-based study.Scandinavian journal of primary health care · 2026Article
- International variation in child healthcare practices and implications for childhood cancer diagnosis: a scoping review and cross-country clinician survey.European journal of pediatrics · 2026Article
- Video-supported telephone triage in emergency primary healthcare: an observational study from Norway.BMJ open · 2026Observational
- Observational
- Understanding language barriers at the registration desk of an after-hours clinic: a qualitative observational study.BMJ public health · 2026Article
- Why do patients attend out-of-hours GP services in Ireland?Irish journal of medical science · 2025Article
- Task shifting from general practitioners to nurses in out-of-hours primary care: an explorative case study of team-based practices.Scandinavian journal of primary health care · 2025Article
- Adverse working conditions in Romanian out-of-hours primary care (OOH-PC): an interview study.Human resources for health · 2025Article
- Observational
- The overlooked challenges facing out-of-hours primary care in the NHS: a missed opportunity in policy.BJGP open · 2025Article
- Safety-netting advice documentation in out-of-hours primary care: a retrospective cohort from 2013 to 2020.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Reasons for encounter in video contacts at a Danish out-of-hours primary care service: a questionnaire study.BMJ open · 2024Article
- The need for a broad perspective when assessing value-for-money for out-of-hours primary care.Primary health care research & development · 2024Review
- Reducing patients' rate of frequent attendance through a training intervention for physicians.BMC medical education · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo synthesise international evidence for demand, use and outcomes of primary care out-of-hours health services (OOHS).
designSystematic scoping review. DATA SOURCES: CINAHL; Medline; PsyARTICLES; PsycINFO; SocINDEX; and Embase from 1995 to 2019. STUDY SELECTION: English language studies in UK or similar international settings, focused on services in or directly impacting primary care.
results105 studies included: 54% from mainland Europe/Republic of Ireland; 37% from UK. Most focused on general practitioner-led out-of-hours cooperatives. Evidence for increasing patient demand over time was weak due to data heterogeneity, infrequent reporting of population denominators and little adjustment for population sociodemographics. There was consistent evidence of higher OOHS use in the evening compared with overnight, at weekends and by certain groups (children aged <5, adults aged >65, women, those from socioeconomically deprived areas, with chronic diseases or mental health problems). Contact with OOHS was driven by problems perceived as urgent by patients. Respiratory, musculoskeletal, skin and abdominal symptoms were the most common reasons for contact in adults; fever and gastrointestinal symptoms were the most common in the under-5s. Frequent users of daytime services were also frequent OOHS users; difficulty accessing daytime services was also associated with OOHS use. There is some evidence to suggest that OOHS colocated in emergency departments (ED) can reduce demand in EDs.
conclusionsPolicy changes have impacted on OOHS over the past two decades. While there are generalisable lessons, a lack of comparable data makes it difficult to judge how demand has changed over time. Agreement on collection of OOHS data would allow robust comparisons within and across countries and across new models of care. Future developments in OOHS should also pay more attention to the relationship with daytime primary care and other services. PROSPERO REGISTRATION NUMBER: CRD42015029741.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.