BMJ 1998;316:1502-1505 ( 16 May )

General Practice

Out of hours service in Denmark: evaluation five years after reform

Morten Bondo Christensen, research assistant,  Frede Olesen, professor. 

Research Unit for General Practice, University of Aarhus, 2 DK-8000 Aarhus C, Denmark

Correspondence to: Dr Bondo Christensen MBC{at}alm.aau.dk

Objective: Five years after its introduction, to evaluate the 1992 reform in the out of hours service in Denmark.
Design: Comparison of data before and after reform. Data were collected from published reports, Danish national health statistics, and the Danish trade union for general practitioners.
Setting: Denmark.
Main outcome measures: Number of out of hours services; workload of general practitioners; cost of the service; patient satisfaction.
Results: Five years after the reform, the percentage of telephone consultations had almost doubled, to 48%. Consultations in doctors' surgeries were relatively unchanged, but home visits were much reduced, to 18%. The percentage of doctors who worked 5 hours or more out of hours per week dropped from about 70% to about 50%. Overall patient satisfaction in 1995 was high (72%).
Conclusion: The organisation of the out of hours service, with a fully trained general practitioner in a telephone triage function, is working satisfactorily. Many calls that previously would have required home visits are now dealt with by telephone or through consultations. The out of hours workload for general practitioners has decreased considerably.

Key messages The out of hours reform in Denmark has resulted in an organisation with a fully trained general practitioner performing the telephone triage function Hours on call for general practitioners have decreased considerably Home visits have largely been replaced by telephone consultations Patient satisfaction has declined slightly

---

© BMJ 1998
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study

Hay P Derkx, Jan-Joost E Rethans, Arno M Muijtjens, Bas H Maiburg, Ron Winkens, Harrie G van Rooij, and J André Knottnerus
BMJ 2008 337: a1264. [Abstract] [Full Text] [PDF]

Danish out of hours service is working well
BMJ 1998 316: 0. [Full Text]

This article has been cited by other articles:

• Derkx, H. P, Rethans, J.-J. E, Muijtjens, A. M, Maiburg, B. H, Winkens, R., van Rooij, H. G, Knottnerus, J A. (2008). Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study. BMJ 337: a1264-a1264 [Abstract] [Full text]  
• Giesen, P., Ferwerda, R., Tijssen, R., Mokkink, H., Drijver, R., van den Bosch, W., Grol, R. (2007). Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?. Qual Saf Health Care 16: 181-184 [Abstract] [Full text]  
• Bordman, R., Bovett, M., Drummond, N., Crighton, E. J., Wheler, D., Moineddin, R., White, D., on behalf of the North Toronto Primary Care Resear, (2007). Typology of after-hours care instructions for patients: Telephone survey and multivariate analysis. cfp 53: 450-456 [Abstract] [Full text]  
• Grol, R., Giesen, P., van Uden, C. (2006). After-Hours Care In The United Kingdom, Denmark, And The Netherlands: New Models. Health Aff (Millwood) 25: 1733-1737 [Abstract] [Full text]  
• Giesen, P, Franssen, E, Mokkink, H, van den Bosch, W, van Vugt, A, Grol, R (2006). Patients either contacting a general practice cooperative or accident and emergency department out of hours: a comparison.. Emerg. Med. J. 23: 731-734 [Abstract] [Full text]  
• Moll van Charante, E., Giesen, P., Mokkink, H., Oort, F., Grol, R., Klazinga, N., Bindels, P. (2006). Patient satisfaction with large-scale out-of-hours primary health care in The Netherlands: development of a postal questionnaire. Fam Pract 23: 437-443 [Abstract] [Full text]  
• Dunt, D., Day, S. E, Kelaher, M., Montalto, M. (2006). The impact of standalone call centres and GP cooperatives on access to after hours GP care: a before and after study adjusted for secular trend. Fam Pract 23: 453-460 [Abstract] [Full text]  
• Mc Loughlin, M, Armstrong, P, Byrne, M, Heaney, D, O'Brien, N, Murphy, A. (2005). A comparative study on attitudes, mental health and job stress amongst GPs participating, or not, in a rural out-of-hours co-operative. Fam Pract 22: 275-279 [Abstract] [Full text]  
• Goode, J., Greatbatch, D., O'cathain, A., Luff, D., Hanlon, G., Strangleman, T. (2004). Risk and the Responsible Health Consumer: The Problematics of Entitlement among Callers to NHS Direct. Critical Social Policy 24: 210-232 [Abstract]  
• Leibowitz, R., Day, S., Dunt, D. (2003). 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. Fam Pract 20: 311-317 [Abstract] [Full text]  
• Lattimer, V., Sassi, F., George, S., Moore, M., Turnbull, J., Mullee, M., Smith, H. (2000). Cost analysis of nurse telephone consultation in out of hours primary care: evidence from a randomised controlled trial. BMJ 320: 1053-1057 [Abstract] [Full text]  
• Salisbury, C., Trivella, M., Bruster, S. (2000). Demand for and supply of out of hours care from general practitioners in England and Scotland: observational study based on routinely collected data. BMJ 320: 618-621 [Abstract] [Full text]  
• Lattimer, V., George, S., Thompson, F., Thomas, E., Mullee, M., Turnbull, J., Smith, H., Moore, M., Bond, H., Glasper, A. (1998). Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomised controlled trial. BMJ 317: 1054-1059 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

Untitled

Paul Hobday
bmj.com, 11 Aug 1998 [Full text]

Online poll

Find out more here>> and here>>