Retrospective analysis of a suburban out-of-hours clinic in Belgium

Belche, Jean Luc; Berrewaerts, Marie-Astrid; Burette, Philippe; Lenoir, Anne-Laure; Duchesnes, Christiane; Giet, Didier

doi:10.1179/2295333714y.0000000052

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Most of the encounters within this study were recorded during weekdays (97%), consistent with the 99.5% reported by Turner et al (2017), which may reflect practice closures during weekends. Only 4.6% of encounters were reported outside usualhours, somewhat less than the 7.2% between 0 and 0800 hours reported in a Belgian out-of-hours clinic (Belche et al 2014).…”

Section: Discussionmentioning

confidence: 67%

“…Within usual-hours, check-ups, test results and skin problems (specifically solar keratosis and neoplasm) were more common, and URTI and any injury were more common afterhours. Other studies that examined after-hours diagnoses grouped these into ICPC-2 chapters, thus making a direct comparison difficult (Huibers et al 2011;Belche et al 2014;Turner et al 2017).…”

Section: Table 3 Comparison Of Patient Reasons For Encounter (Rfe) Imentioning

confidence: 99%

“…To date, only one study in a single metropolitan GP clinic in Melbourne has compared patient and encounter characteristics in usual GP hours and after-hours practice (Turner et al 2017). Four European studies have reported characteristics of out-of-hours consultations without comparison to usual GP practice (Huber et al 2011;Huibers et al 2011;Belche et al 2014;Buja et al 2015). There is a gap in the literature for a nationwide comparison of characteristics of GPs, practices, patients and encounters conducted in usual and after-hours GP care.…”

Section: Introductionmentioning

confidence: 99%

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GP services in Australia: presentation profiles during usual practice hours and after-hours periods

Baker

Britt

Harrison

2020

Aust. J. Prim. Health

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After-hours general practitioner (GP) services can reduce emergency department demand, which is currently increasing in Australia. Understanding GP after-hours care may assist in service planning. From April 2014 to March 2015, 986 GPs recorded 38275 consultations with start and finish times in the Bettering the Evaluation and Care of Health (BEACH) study, a national, cross-sectional, representative study of GP activity. GP and patient characteristics and the content of encounters in usual-hours and after-hours were compared. Significantly more after-hours than usual-hours encounters were with: GPs aged 60+ years; in metropolitan practices; and practices with 10+ GPs. Patients seen after-hours were more often: male; aged 15–64 years; new to practice; and less likely to hold a Commonwealth Concession Card. They were more likely to be prescribed antibiotics and less likely to: have chronic problems managed; be referred; receive psycholeptic or psychoanaleptic prescription; and undergo a procedure. Throat symptoms, fever and injury were more common reasons for encounter, while infections and injury were more frequently managed problems after-hours. The patient mix, GP characteristics, problems managed and management actions in after-hours care differ from those in usual-hours care in Australia. This greater understanding of after-hours care is the first step to informed resource allocation to improve the delivery of after-hours primary care.

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Section: Discussionmentioning

confidence: 67%

Section: Table 3 Comparison Of Patient Reasons For Encounter (Rfe) Imentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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GP services in Australia: presentation profiles during usual practice hours and after-hours periods

Baker

Britt

Harrison

2020

Aust. J. Prim. Health

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“…This finding could result from the current organization of healthcare or because of their increased workload due to the increasing shortage of their profession [2]. Indeed, during out-of-hours periods, regulation systems have been established in Belgium and probably, interact favorably with these results [16][17][18]. Likewise, other countries have noticed such similar effects [19,20].…”

Section: Discussionmentioning

confidence: 99%

“…As concerns primary care physicians' accessibility in modern healthcare world, several authors have advocated the efficiency of primary health-care facilities located near EDs to alleviate ED attendance with patients in need of primary care. This method has been experienced in some location in Belgium and Europe with hopeful and reliable results [6,9,12,16,[24][25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Emergency department crowding: why do patients walk-in?

Brasseur

Gilbert

Servotte

et al. 2019

Acta Clinica Belgica

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Objectives: For years, general practitioners (GP) shortage and patients' increasing demand for acute care have been associated with Emergency Department (ED) crowding. Indeed, EDs admissions for non-emergency care seem to constantly increase. Surprisingly, the rationale for patients own decision to directly reach EDs over primary care have been poorly investigated to date. Methods: We conducted a study on patients admitted in two University EDs during nine consecutive days. Patients were asked to answer a survey about their frames for coming and if they were self-referred, referred by a GP, a specialist or after calling the Emergency Number. Results: During the study period, 68.0% of patients were self-referred, 17.0% referred by their GP, 8.5% by a specialist and 7% after an emergency call. 51.0% of the self-referrals thought EDs were the appropriate location to deal with their health problem and 24.0% because of a better accessibility. We noticed that 15.0% of the incomings looked for specialized care and 4.22% reported that the stress had motivated them. Of note, 4.6% of the patients were attracted by the hospital reputation. Financial concerns represented less than 1.0% of the motives invocated. Conclusion: We found that patients' self-perceived severity of illness is the predominant frame to each the ED when they face needs for acute care. EDs' accessibility as compared with other facilities also seems to encourage patients to come to the ED. Other factors such as the hospital reputation or patients' stress tend to influence ED attendance but to a much lesser extent.

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Characteristics of patients presenting to an after-hours clinic: results of a MAGNET analysis

Turner

Pearce

Borg³

et al. 2017

Aust. J. Prim. Health

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After-hours access to general practice (GP) is critical to supporting accessibility and reducing emergency department demand. To understand who utilises after-hours GP services, this study examined the characteristics of presentations to an Eastern Melbourne after-hours clinic between 2005 and 2014. Descriptive analyses of patient and presentation characteristics, diagnoses, medications and pathology were conducted. Across the study period, 39.1% of presentations to the clinic (N=64,800) were by patients under 18 years of age. Females were found to attend more often than males, and nearly 79% of patients attended only once. The most common diagnoses were respiratory system diseases (13.4%), gastrointestinal system diseases (12.6%) and eye and ear problems (11.6%). Antibacterial medications accounted for over half (53.0%) of all prescriptions, with 34% of antibiotics prescribed to patients under 18 years of age. Seasonal variation in GP demand was also observed. Presenting patients differed from the wider GP patient population, with more young patients, and a higher proportion of prescriptions for antibacterial medications compared to other predominantly non-after-hours practices. Further research is required to understand the health-seeking, decision-making of patients who utilise after-hours GPs over predominantly non-after-hours primary care services, to inform service promotion and delivery strategies.

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Retrospective analysis of a suburban out-of-hours clinic in Belgium

Cited by 5 publications

References 6 publications

GP services in Australia: presentation profiles during usual practice hours and after-hours periods

GP services in Australia: presentation profiles during usual practice hours and after-hours periods

Emergency department crowding: why do patients walk-in?

Characteristics of patients presenting to an after-hours clinic: results of a MAGNET analysis

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