Abstract
BackgroundIn the Netherlands, the increase in of out-of-hours care that is provided by GP co-operatives is challenging the continuity of care for the terminally ill in general practice. Aim of this study is to investigate the views of general practitioners (GPs) on the transfer of information about terminally ill patients to the GP co-operatives. GPs were asked to give their view from two different perspectives: as a GP in their daily practice and as a locum in the GP co-operative.MethodsRetrospective web based questionnaire sent to all 424 GPs in the Amsterdam region.ResultsWith a response rate of 42%, 177 physicians completed the questionnaire. Transfer of information to the GP co-operative about most of their terminally ill patients was reported by 82% of the GPs and 5% did not do so for any of their patients. A faster than foreseen deterioration of the patient's situation was the most frequently reported reason for not transferring information.Of those who transferred information to the GP co-operative, more than 95% reported that they provided information about the diagnosis and terminally ill status of the patient. Information about medication, patient wishes regarding treatment, and prognosis was reported by respectively 90%, 87%, and 74% of the GPs. Less than 50% of the GPs reported that they transferred information about the patient's awareness of both the diagnosis and the prognosis, about the psychosocial context, and intolerances.In their role as locum, over 90% of the GPs wanted to receive information about the diagnosis, the terminally ill status of the patient, the medication and the patient's wishes regarding treatment.ConclusionsAlthough most GPs reported that they transferred information about their terminally ill patients to the GP co-operative, the content of this information varies considerably. Only 21% of the GPs, working out of hours as a locum, were satisfied with the quality of the information transferred.
Highlights
In the Netherlands, the increase in of out-of-hours care that is provided by general practitioners (GPs) cooperatives is challenging the continuity of care for the terminally ill in general practice
Conclusions: most GPs reported that they transferred information about their terminally ill patients to the GP co-operative, the content of this information varies considerably
The email questionnaire was completed by 175 GPs and the postal version by four GPs, two of whom were excluded from the data analysis due to incomplete answers
Summary
In the Netherlands, the increase in of out-of-hours care that is provided by GP cooperatives is challenging the continuity of care for the terminally ill in general practice. From 1999 on, GPs in the Netherlands have reorganised their out-of-hours care from rota groups to larger scale GP co-operatives with 40400 GPs taking care of populations ranging from 50.000700.000 inhabitants [4,5] These co-operatives provide out-of-hours GP care for more than 90% of the Dutch population. They are organised by and responsible to a board of local GPs
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