Irish medical journal
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Irish medical journal · Mar 2006
General practice out-of-hours co-operatives--population contact rates.
Since 1998, Irish general practice has developed 11 out-of-hours co-operatives, covering almost 40% of the population. The co-operatives vary in terms of triage mechanisms, treatment centres and domiciliary visits. Out-of-hours consultation rates for the GMS sector of the population (one-third of the population who receive free primary care on the basis of low income) have increased rapidly to 438 consultations/1000 persons/year by 2003. ⋯ Two distinct bands of contact rates emerged - seven of eight rural co-operatives (all with domiciliary services) have a range of 220-300 contacts/1000 persons/year while three urban co-operatives (none of which have integrated domiciliary services) have a range of 70-90 contacts/1000 persons/year. These results are explored in the context of UK and Danish data, with which they compare. The implications of the urban/rural banding are significant and require early further research.
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The transfer of critically ill patients between hospitals carries significant risk. The Mobile Intensive Care Ambulance Service (MICAS) in Ireland was established in 1996 to provide a ground transfer service between hospitals for critically ill patients. ⋯ There were no patient deaths during transfer. 47% of transfers were between hospitals in the greater Dublin area. 45% were from regional centres to Dublin. 93% of patients required airway intervention before transfer (intubation or tracheostomy) and 32% needed inotropic support during transfer. The MICAS data confirm the demand for interhospital transport of critically ill patients and suggest that transfer using a centralised retrieval system is safe.