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Fam Pract. 2016 Oct;33(5):504-9. doi: 10.1093/fampra/cmw048. Epub 2016 Jun 21.

Out-of-hours primary care: a population-based study of the diagnostic scope of telephone contacts.

Author information

1
The Research Unit for General Practice, Aarhus University, Aarhus, Denmark. moth@ph.au.dk.
2
The Research Unit for General Practice, Aarhus University, Aarhus, Denmark.

Abstract

BACKGROUND:

GPs answer all patient calls to the out-of-hours primary care (OOH-PC) services in Denmark. Knowledge is scarce on how the triage-GPs act on the specific reasons for encounter (RFE).

OBJECTIVE:

This study aims to describe the RFEs, the applied diagnoses and the severity of health problems presented in calls to the OOH-PC.

METHODS:

This was a 1-year cross-sectional study based on IT-integrated pop-up questionnaires addressing patients' health problems. We included only telephone contacts that were categorized according to their triage outcome as telephone consultations, direct admissions to hospital or referrals for face-to-face contact. The GP-assessed severity was calculated for age groups and types of outcome. We identified the 20 most frequent primary RFEs and diagnoses for each type of contact termination.

RESULTS:

We included 7810 telephone calls. Calls considered non-severe made up two-thirds of the calls terminated as telephone consultations, whereas calls considered potentially severe made up the main part of referrals (52.3%). Overall, the 20 most frequent RFEs accounted for 45.2% of all RFEs, fever being the most frequent (10.0%). Some RFEs were terminated mostly as telephone consultations [e.g. insect bite/sting (75.9%)], whereas others were most often referred for a face-to-face contact [i.e. dyspnoea (79.1%)] or directly to hospital [i.e. chest pain (29.4%)].

CONCLUSION:

The distribution of the RFEs on triage outcomes, dominated by more severe diagnoses in referrals indicates a suitable referral level. However, future research on factors related to the demanding task of telephone triage is highly relevant for postdoctoral training of GPs.

KEYWORDS:

After hours; Denmark; diagnosis; primary health care; reason for encounter; severity; triage.

PMID:
27328678
DOI:
10.1093/fampra/cmw048
[Indexed for MEDLINE]

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