Abstract
Introduction
The aim of this study was to describe the characteristics of
patients admitted to an Out-of-Hours service (OoHs), the
related outputs and to analyse deeply the frequent attenders
(FAs)’s phenomena.
Methods
This study was a retrospective cohort study on electronic
population-based records, linked with the mortality registry
and with patients’ exemption from health care charges. A FA
was defined as a patient with 3 contacts in 12 months. A
logistic regression model was constructed to identify independent
variables associated with this outcome.
Results
23,980 OoHs contacts (CTCs) in 2011 at a Local Health
Authority in the Veneto Region were registered. Rates were
higher for the oldest and youngest age groups and for females.
More than half of CTCs concerned patients who were seen by a
physician, about 1/3 of CTCs related problems managed by
phone, about 10% of CTCs were referred to other services.
Many factors, including demographic, process-logistic and
clinical variables were associated with the decision to visit the
patient (rather than provide a phone advice), or to refer
patients to ED or to a specialist. Some OOH doctors were
more likely than their colleagues to refer a patient to ED. FA
status was associated with clinical variables (such as psychiatric
disease), socio-demographic variables (sex, age and income
level), and also with the feature of their GPs’ association.
Conclusion
Our study shows that OoHs meet composite and variously
expressed demands. The determining factors associated with
cases referred to other health care services should be
considered when designing clinical pathways in order to
ensure a continuity of care. The unwarranted variability in
OOH physicians’ performance needs to be addressed. The
determinants of OoHs FA include patients’ clinical conditions,
several socio-economic characteristics (including income level)
and their GPs’ organizational format.
Key message
This is the first study found that also socio-demographic
and logistic features of the contact change the propensity
of OOH physician to refer patients to ED or to specialist
visit.
Lingua originale | English |
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pagine (da-a) | 285-285 |
Numero di pagine | 1 |
Rivista | European Journal of Public Health |
Volume | 25 (Suppl. 3) |
Stato di pubblicazione | Pubblicato - 2015 |
Evento | 8th European Public Health Conference – “Health in Europe – from global to local policies, methods and practices” - Milano Durata: 14 ott 2015 → 17 ott 2015 |
Keywords
- Out-of-Hours service