Seven-day access to NHS primary care: how does England compare with Europe?

Rosenberg-Wohl, Sarah; Greenfield, Geva; Majeed, Azeem; Hayhoe, Benedict

doi:10.1177/0141076818755557

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…A combination of two factors possibly result in this finding; the lack of knowledge of the recommended care pathways for symptoms associated with Lyme disease (such as flu-like illness and rashes), and the difficulty in getting a prompt appointment in primary care [12, 34–37]. Peak non-urgent attendance at NHS emergency departments has been recorded at weekends [38], which may be due to the lack of access to primary care at the weekend [12, 35–37, 39]. However, our data show that the number of cases appearing in A&E is relatively evenly distributed throughout week, suggesting that the lack of knowledge of where to seek help with Lyme disease symptoms may be the predominant cause of the above findings.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (1998–2015)

et al. 2019

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Background Lyme disease is a tick-borne disease of increasing global importance. There is scant information on Lyme disease patient demographics in England and Wales, and how they interact with the National Health Service (NHS). Our aims were to explore the demographic characteristics of Lyme disease patients within the Hospital Episode Statistics (HES) and Patient Episode Database for Wales (PEDW), and to describe patient pathways. Methods Data from 1st January 1998 to 31st December 2015 was retrieved from the two administrative hospital datasets (HES and PEDW), based on patients coded with Lyme disease. Information was collected on demographic characteristics, home address and case management. Incidence rates were calculated, and demographics compared to the national population. Results Within HES and PEDW, 2361 patients were coded with Lyme disease. There was a significant increase ( p < 0.01) in incidence from 0.08 cases/100,000 in 1998, to 0.53 cases/100,000 in 2015. There was a bimodal age distribution, patients were predominantly female, white and from areas of low deprivation. New cases peaked annually in August, with higher incidence rates in southern central and western England. Within hospital admission data ( n = 2066), most cases were either referred from primary care (28.8%, n = 596) or admitted via accident and emergency (A&E) (29.5%, n = 610). This population entering secondary care through A&E suggest a poor understanding of the recommended care pathways for symptoms related to Lyme disease by the general population. Conclusions These data can be used to inform future investigations into Lyme disease burden, and patient management within the NHS. They provide demographic information for clinicians to target public health messaging or interventions.

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Section: Discussionmentioning

confidence: 99%

Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (1998–2015)

et al. 2019

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“…Comparing opening hours of other European countries and the UK 21 , we see that opening hours vary widely across countries the majority having longer opening hours then Romania, ranging from 7 to 12h. Only Hungary and Lithuania are reporting lower times (2 to 6 hours a day).…”

Section: Resultsmentioning

confidence: 92%

Population’s perceptions and availability of primary care services in Romania- a pilot survey in County Brasov.

Neculau¹,

Rogozea²,

Popa³

et al. 2019

Preprint

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Background National health reports on Romania show that decisions in healthcare planning are not correlated with the health needs of the population and that there is a high degree of unmet healthcare needs of the population (related to cost, distance and waiting times), especially for low-income populations. Family medicine is facing underfinancing, slow pace of development. Methods The research is part of a wider project of health services needs assessment in county Brasov, Romania. A subset of questions where dedicated to identifying the perception of population on primary healthcare services. Comparison with previous national and international studies was done. Results The characteristics of the population questioned: predominantly women (67.2%), 61.1% graduates of high school or other professional schools. 97.4% are registered with a FD. The average number of visits at the FD is 11.25, higher than the national average of 7.7 reported in a previous study in 2009. Access to the FD is appreciated as satisfactory in terms of availability of doctors in the community (97.4%), opening times by (91.1%), phone access (90.5%). Only 26.6% of participants reported a same day opportunity to reach the FD. Continuity of care is reported as present in 58.7% of cases in out of hours centres. The population is appreciating the fact that FDs knows their history (90%), knows how to treat them (88.2%). Most of the preventative services are offered by FDs. 94.4% flu vaccination, 85.6% pregnancy monitoring, 90.7% well child visits. Procedures like blood draws, pap smear have less availability (46.2% respectively 63.1%). Conclusions Despite limitations in the practice of family medicine in Romania and therefore a narrow spectrum of services offered by primary care in general, the level of contentment of the population with this healthcare resource is still high. Barriers to access are related to the lack of some essential services, especially preventive and out-of-hours services. Research at national level should be done in order to better categorize population’ perceptions on primary care and be able to use their opinion to influence policies and healthcare planning. Key words: unmet health needs, population’s perception, primary care, Romania

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“…In a national survey, only 29% of American doctors said they had the necessary measures at their clinic to provide out‐of‐hours medical care . Since 2004, in the United Kingdom, following the physicians' choice to provide after‐hours primary cares, they provided these care through contracting with private companies . In the Netherlands, almost all physicians are members of the GP co‐operatives.…”

Section: Discussionmentioning

confidence: 99%

The response of health systems to after‐hours primary cares in Iran and the selected countries

Salemi

Aryankhesal

Jafari

2019

Health Planning & Management

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Summary Background After‐hours primary care often involves care required for medical conditions managed outside hospitals by a general practitioner. After‐hours care aims at meeting the urgent needs of patients who cannot wait to visit their general practitioner in office hours. Aim The present study aims at comparing the after‐hours primary cares in Iran, Turkey, the United States, the Netherlands, Australia, and the United Kingdom. Method This is a descriptive‐comparative study comparing after‐hours primary cares in Iran and selected countries in 2019. Considering the research purpose, data pertaining to each country were collected from valid information sources and the countries were compared based on the comparative table. A framework analysis was used for data analyses. Results The results were stated regarding the model type, dominant model, payments mechanism, the support of insurance organizations, service tariffs, private sector participation, and participation of primary care general practitioners in each country. Conclusions Different countries are using diverse policies to enhance patients' access to general practitioners in out‐of‐office hours. In Iran, however, due to the lack of specific policies to access after‐hour primary cares, people have to use expensive hospital and private cares. An essential step in solving this problem is the availability of general practitioner services at primary care level.

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Seven-day access to NHS primary care: how does England compare with Europe?

Cited by 9 publications

References 11 publications

Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (1998–2015)

Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (1998–2015)

Population’s perceptions and availability of primary care services in Romania- a pilot survey in County Brasov.

The response of health systems to after‐hours primary cares in Iran and the selected countries

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