General practitioners' satisfaction with and attitudes to out-of-hours services

Caro Jt Van Uden,Gemma Bwe Voss,Fred Hm Nieman,Geertjan Wesseling,Harry Fjm Crebolder,Ron Ag Winkens

doi:10.1186/1472-6963-5-27

Caro Jt Van Uden, Gemma Bwe Voss + Show 4 more

Open Access

https://doi.org/10.1186/1472-6963-5-27

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Abstract

BackgroundIn recent years, Dutch general practitioner (GP) out-of-hours service has been reorganised into large-scale GP cooperatives. Until now little is known about GPs' experiences with working at these cooperatives for out-of-hours care. The purpose of this study is to gain insight into GPs' satisfaction with working at GP cooperatives for out-of-hours care in separated and integrated cooperatives.MethodsA GP cooperative separate from the hospital Accident and Emergency (A&E) department, and a GP cooperative integrated within the A&E department of another hospital. Both cooperatives are situated in adjacent geographic regions in the South of the Netherlands. One hundred GPs were interviewed by telephone; fifty GPs working at the separated GP cooperative and fifty GPs from the integrated GP cooperative. Opinions on different aspects of GP cooperatives for out-of-hours care were measured, and regression analysis was performed to investigate if these could be related to GP satisfaction with out-of-hours care organisation.ResultsGPs from the separated model were more satisfied with the organisation of out-of-hours care than GPs from the integrated model (70 vs. 60 on a scale score from 0 to 100; P = 0.020). Satisfaction about out-of-hours care organisation was related to opinions on workload, guarantee of gatekeeper function, and attitude towards out-of-hours care as being an essential part of general practice. Cooperation with medical specialists was much more appreciated at the integrated model (77 vs. 48; P < 0.001) versus the separated model.ConclusionGPs in this study appear to be generally satisfied with the organisation of GP cooperatives for out-of-hours care. Furthermore, GPs working at the separated cooperative seem to be more satisfied compared to GPs working at the integrated cooperative.

Highlights

In recent years, Dutch general practitioner (GP) out-of-hours service has been reorganised into large-scale GP cooperatives
It is known that a substantial number of self-referred patients at the A&E department exhibit minor injuries or nonurgent ailments that can be treated by a GP [3,4]
In total the questionnaire consisted of 86 items. (Some items are excluded from the analysis because they are only of local interest.) We investigated opinions on: overall satisfaction with the GP cooperative for out-of-hours, reorganisation of out-of-hours care, perceived workload, out-of-hours care as being an essential part of primary care, anonymity of care, gatekeeper function, availability of patient dossiers, cooperation with medical specialists during out-of-hours, and safety

Summary

Introduction

Dutch general practitioner (GP) out-of-hours service has been reorganised into large-scale GP cooperatives. In the separated model the GP cooperative is located separate from the hospital's accident and emergency (A&E) department, indicating that there is no functional integration of out-ofhours services. In this model patients with a medical problem can choose between attending the GP cooperative or the A&E department, during out-of-hours. In the second organisation model the GP cooperative is integrated with the hospital A&E department In this model, all patients utilising out-of-hours primary and emergency care without referral are first seen by a GP or practice nurse.

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