• J Am Board Fam Med · Nov 2015

    Observational Study

    Out-of-Hours Care Collaboration between General Practitioners and Hospital Emergency Departments in the Netherlands.

    • Elisabeth Sybilla Johanna van Gils-van Rooij, Christoffel Joris Yzermans, Sjoerd Michael Broekman, Berthold Rudy Meijboom, Gerben Paul Welling, and Dingenus Herman de Bakker.
    • From Scientific Center for Transformation in Care and Welfare (Tranzo), Tilburg University, Tilburg, the Netherlands (ESJvG-vR, BRM, DHdB); GP Cooperative Zuidoost Brabant, Eindhoven, the Netherlands (ESJvG-vR, GPW); and The Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands (CJY, SMB, DHdB). l.vanrooij@spoedpost.nu.
    • J Am Board Fam Med. 2015 Nov 1; 28 (6): 807-15.

    ObjectiveIn the Netherlands, general practitioners (GPs) and emergency departments (EDs) collaborate increasingly in what is called an Urgent Care Collaboration (UCC). In UCCs, GPs and EDs share 1 combined entrance and joint triage. The objective of this study was to determine if GPs treat a larger proportion of out-of-hours patients in the UCC system, and how this relates to patient characteristics.MethodsThis observational study compared patients treated within UCCs with patients treated in the usual care setting, that is, GPs and EDs operating separately. Data on the characteristics of the patients, their consultations, and their health problems were derived from electronic medical records. We performed χ(2) tests, independent sample t tests, and multiple logistic regression analyses.ResultsA significantly higher proportion of patients attended their on-call GP within the UCC system. The proportion of ED patients was 22% smaller in UCCs compared to the usual care setting. Controlled for patient and health problem characteristics the difference remained statistically significant (OR=0.69; CI 0.66-0.72) but there were substantial differences between regions. Especially patients with trauma were treated more by general practitioners. Controlled for case mix, patients in the largest UCC-region were 1.2 times more likely to attend a GP than the reference group.ConclusionWhen GPs and EDs collaborate, GPs take a substantially higher proportion of all out-of-hours patients.© Copyright 2015 by the American Board of Family Medicine.

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