Literature DB >> 19826163

After-hours services in capitation-funded primary care practice: use and satisfaction.

Ieva Neimanis1, Janusz Kaczorowski, Michelle Howard.   

Abstract

OBJECTIVE: To examine patients' use of and satisfaction with the nurse-staffed Telephone Health Advisory Service (THAS) and physician after-hours care in a rostered Family Health Organization, as well as physicians' satisfaction with both types of services.
DESIGN: Cross-sectional telephone survey.
SETTING: A Family Health Organization in Hamilton, Ont. PARTICIPANTS: Nineteen family physicians and their patients who used an after-hours service during 9 selected weeks between March and December of 2007. MAIN OUTCOME MEASURES: Distribution of encounters directed to the on-call physician or to the THAS; types of health problems; and patient and physician satisfaction.
RESULTS: A total of 817 calls were recorded from 774 patients. Of these patients, 606 were contacted and 94.4% (572/606) completed encounter-specific surveys: 358 completed the on-call physician survey and 214 completed the THAS survey. Mean age of respondents was 40.8 years; most were women, and approximately one-third called on behalf of children. Most calls (66.8%, 546/817) were made directly to the on-call physicians. The most common problems were respiratory (34.3%, 271/789), gastrointestinal (10.1%, 80/789), and genitourinary (9.3%, 73/789). Most patients reported being very satisfied with the after-hours care provided by the THAS (62.5%, 125/200) or the on-call physicians (70.9%, 249/351). Almost all callers who bypassed the THAS knew about it (89.8%, 316/352), but either felt their problems were too serious or wished to talk to a physician. Most physicians agreed or strongly agreed that they were satisfied with their colleagues' on-call care (81.0%, 17/21); 47.6% (10/21) agreed that the THAS was helpful in managing on-call duty.
CONCLUSION: When direct after-hours physician contact is available, a minority of patients uses a nurse-staffed triage. Physicians find the arrangements onerous and would prefer to see after-hours care managed and remunerated differently.

Entities:  

Mesh:

Year:  2009        PMID: 19826163      PMCID: PMC2761961     

Source DB:  PubMed          Journal:  Can Fam Physician        ISSN: 0008-350X            Impact factor:   3.275


  12 in total

1.  Telephone triage in Western Australia.

Authors:  Valendar F Turner; Peter J Bentley; Sharon A Hodgson; Peter J Collard; Rosalia Drimatis; Catherine Rabune; Andrew J Wilson
Journal:  Med J Aust       Date:  2002-02-04       Impact factor: 7.738

2.  After-hours information given by telephone by family physicians in ontario.

Authors:  Michelle Howard; Glen E Randall
Journal:  Healthc Policy       Date:  2009-11

Review 3.  Telephone consultation and triage: effects on health care use and patient satisfaction.

Authors:  F Bunn; G Byrne; S Kendall
Journal:  Cochrane Database Syst Rev       Date:  2004-10-18

4.  Should general practitioners resume 24 hour responsibility for their patients? No.

Authors:  Helen Herbert
Journal:  BMJ       Date:  2007-10-06

5.  Patient satisfaction with out of hours primary medical care.

Authors:  R K McKinley; C Roberts
Journal:  Qual Health Care       Date:  2001-03

6.  Patients evaluate accessibility and nurse telephone consultations in out-of-hours GP care: determinants of a negative evaluation.

Authors:  Paul Giesen; Eric Moll van Charante; Henk Mokkink; Patrick Bindels; Wil van den Bosch; Richard Grol
Journal:  Patient Educ Couns       Date:  2006-08-30

7.  The effect of health status on patients' satisfaction with out-of-hours care provided by a family doctor co-operative.

Authors:  L G Glynn; M Byrne; J Newell; A W Murphy
Journal:  Fam Pract       Date:  2004-11-04       Impact factor: 2.267

Review 8.  A systematic review of the effect of different models of after-hours primary medical care services on clinical outcome, medical workload, and patient and GP satisfaction.

Authors:  Ruth Leibowitz; Susan Day; David Dunt
Journal:  Fam Pract       Date:  2003-06       Impact factor: 2.267

9.  Meeting patient expectations of care: the major determinant of satisfaction with out-of-hours primary medical care?

Authors:  R K McKinley; K Stevenson; S Adams; T K Manku-Scott
Journal:  Fam Pract       Date:  2002-08       Impact factor: 2.267

10.  Nurse telephone triage in out-of-hours GP practice: determinants of independent advice and return consultation.

Authors:  Eric Peter Moll van Charante; Gerben ter Riet; Sara Drost; Loes van der Linden; Niek S Klazinga; Patrick J E Bindels
Journal:  BMC Fam Pract       Date:  2006-12-12       Impact factor: 2.497

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  2 in total

1.  After-hours information given by telephone by family physicians in ontario.

Authors:  Michelle Howard; Glen E Randall
Journal:  Healthc Policy       Date:  2009-11

2.  Fatigue risk management revisited.

Authors:  Francine Lemire
Journal:  Can Fam Physician       Date:  2017-08       Impact factor: 3.275

  2 in total

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