Twenty four hour care in inner cities.

Main, J A; Main, Paul

doi:10.1136/bmj.299.6699.627-b

Cited by 11 publications

(2 citation statements)

References 1 publication

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“…24 This study clearly shows that high rates also exist in more privileged areas, and we believe that this phenomenon is due to patients expecting a 24 hour general medical service.…”

Section: Discussionmentioning

confidence: 60%

Out of hours workload of a suburban general practice: deprivation or expectation.

Pitts

Whitby

1990

BMJ

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The out of hours workload of a training practice in a suburban and semirural area on the south coast of England was studied for one year. An overall rate of contact of 273/1000 patients was found, which indicated a workload greater than that reported in most other studies. The duty doctor received over 35 telephone calls from patients during some Saturdays (1200 Saturday to 0800 Sunday) and Sundays (0800 to 0800 Monday), up to five being between 2300 and 0700. Of the patients who contacted a general practitioner, 44% were given advice by telephone and 4 9% were admitted to hospital. The admission rate was lower than that given in other studies. A considerable proportion of the workload arose from doctors covering the casualty department of a cottage hospital. Patients having a high expectation of 24 hour care by general practitioners in an area of comparative affluence (Jarman indices -13-8 to 1.7) may account for this aspect of the workload.

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“…24 This study clearly shows that high rates also exist in more privileged areas, and we believe that this phenomenon is due to patients expecting a 24 hour general medical service.…”

Section: Discussionmentioning

confidence: 60%

Out of hours workload of a suburban general practice: deprivation or expectation.

Pitts

Whitby

1990

BMJ

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“…The overall increase and wide variations in demand between practices and regions for out of hours care need to be explained. Social deprivation, high expectations in affluent areas, and high proportions of young children are associated with higher rates of out of hours calls 2 3 4 5 6 7 8. Studies looking at the relation between supply and demand have suggested that organisational factors such as use of a deputising service, list size, number of partners, aspects of the doctor-patient relationship, and the attitudes of doctors themselves may explain the variations 9 10 11 12…”

Section: Introductionmentioning

confidence: 99%

Patients' accounts of calling the doctor out of hours: qualitative study in one general practice

Hopton

Hogg²,

McKee³

1996

BMJ

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The pursuit of a model of out of hours care based on medical necessity that neglects the psychosocial context of illness may not be appropriate. The importance of previous experiences of health services and contacts with health professionals in explaining current service use requires wider acknowledgement by health professionals across sectors. Separate educational programmes to encourage patients to use out of hours services more appropriately that neglect these issues may be too simplistic.

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‘Do I don’t I call the doctor’: a qualitative study of parental perceptions of calling the GP out‐of‐hours

Houston

Pickering

2000

Health Expectations

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The purpose of this study was to investigate how parents use the GP out‐of‐hours service. There was a lack of information about how parents managed childhood illness and what strategies they put in place to help them to cope before calling the GP. The investigation of parental perceptions was based on a qualitative design using in‐depth interviews of 29 families from a semi‐rural location in the south‐east of England. All parents said they found dealing with a sick child out‐of‐hours stressful and were concerned to make the right decision for their child. Furthermore, parents usually employed a reasonable strategy in attempting to manage the child’s illness. This study demonstrated that the decision to call the doctor was not taken lightly. Many parents had implemented useful strategies prior to calling the doctor. However, most parents were also aware of their limitations and feared doing the wrong thing. It would seem that on occasion this fear combined with factors such as a lack of social support and loss of parental confidence resulted in calling the doctor out of hours to seek ‘peace of mind’. A rethink is needed among health professionals about the ‘problem’ of out‐of‐hours calls. GPs could actively seek to empower parents by educating them about minor illness during visits and consultations. It is not enough to offer reassurance to parents that their children are fine. Health visitors and other health professionals who come into contact with young families may help to educate and empower.

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Twenty four hour care in inner cities.

Cited by 11 publications

References 1 publication

Out of hours workload of a suburban general practice: deprivation or expectation.

Out of hours workload of a suburban general practice: deprivation or expectation.

Patients' accounts of calling the doctor out of hours: qualitative study in one general practice

‘Do I don’t I call the doctor’: a qualitative study of parental perceptions of calling the GP out‐of‐hours

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