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Out-of-hours primary care in 26 European countries: an overview of organizational models.
Fam Pract. 2020 Jun 29 [Online ahead of print]FP

Abstract

BACKGROUND

Various models exist to organize out-of-hours primary care (OOH-PC). We aimed to provide an up-to-date overview of prevailing organizational models in the European Union (EU), implemented changes over the last decade and future plans. This baseline overview may provide information for countries considering remodelling their OOH-PC system.

METHODS

A cross-sectional web-based questionnaire among 93 key informants from EU countries, Norway and Switzerland. Key informants with expertise in the field of primary health care were invited to participate. Themes in the questionnaire were the existing organizational models for OOH-PC, model characteristics, major organizational changes implemented in the past decade and future plans.

RESULTS

All 26 included countries had different coexisting OOH-PC models, varying from 3 to 10 models per country. 'GP cooperative was the dominant model in most countries followed by primary care centre and rota group'. There was a large variation in characteristics between the models, but also within the models, caused by differences between countries and regions. Almost all countries had implemented changes over the past 10 years, mostly concerning the implementation of telephone triage and a change of organizational model by means of upscaling and centralization of OOH-PC. Planned changes varied from fine-tuning the prevailing OOH-PC system to radical nationwide organizational transitions in OOH-PC.

CONCLUSIONS

Different organizational models for OOH-PC exist on international and national level. Compared with a decade ago, more primary care-oriented organizational models are now dominant. There is a trend towards upscaling and centralization; it should be evaluated whether this improves the quality of health care.

Authors+Show Affiliations

Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.Research Unit for General Practice Aarhus, University of Aarhus, Aarhus, Denmark.Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32597962

Citation

Steeman, Luca, et al. "Out-of-hours Primary Care in 26 European Countries: an Overview of Organizational Models." Family Practice, 2020.
Steeman L, Uijen M, Plat E, et al. Out-of-hours primary care in 26 European countries: an overview of organizational models. Fam Pract. 2020.
Steeman, L., Uijen, M., Plat, E., Huibers, L., Smits, M., & Giesen, P. (2020). Out-of-hours primary care in 26 European countries: an overview of organizational models. Family Practice. https://doi.org/10.1093/fampra/cmaa064
Steeman L, et al. Out-of-hours Primary Care in 26 European Countries: an Overview of Organizational Models. Fam Pract. 2020 Jun 29; PubMed PMID: 32597962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Out-of-hours primary care in 26 European countries: an overview of organizational models. AU - Steeman,Luca, AU - Uijen,Maike, AU - Plat,Erik, AU - Huibers,Linda, AU - Smits,Marleen, AU - Giesen,Paul, Y1 - 2020/06/29/ PY - 2020/6/30/entrez KW - After hours care KW - European Union KW - organizational models KW - out-of-hours medical care KW - practitioner cooperative KW - primary health care JF - Family practice JO - Fam Pract N2 - BACKGROUND: Various models exist to organize out-of-hours primary care (OOH-PC). We aimed to provide an up-to-date overview of prevailing organizational models in the European Union (EU), implemented changes over the last decade and future plans. This baseline overview may provide information for countries considering remodelling their OOH-PC system. METHODS: A cross-sectional web-based questionnaire among 93 key informants from EU countries, Norway and Switzerland. Key informants with expertise in the field of primary health care were invited to participate. Themes in the questionnaire were the existing organizational models for OOH-PC, model characteristics, major organizational changes implemented in the past decade and future plans. RESULTS: All 26 included countries had different coexisting OOH-PC models, varying from 3 to 10 models per country. 'GP cooperative was the dominant model in most countries followed by primary care centre and rota group'. There was a large variation in characteristics between the models, but also within the models, caused by differences between countries and regions. Almost all countries had implemented changes over the past 10 years, mostly concerning the implementation of telephone triage and a change of organizational model by means of upscaling and centralization of OOH-PC. Planned changes varied from fine-tuning the prevailing OOH-PC system to radical nationwide organizational transitions in OOH-PC. CONCLUSIONS: Different organizational models for OOH-PC exist on international and national level. Compared with a decade ago, more primary care-oriented organizational models are now dominant. There is a trend towards upscaling and centralization; it should be evaluated whether this improves the quality of health care. SN - 1460-2229 UR - https://www.unboundmedicine.com/medline/citation/32597962/Out-of-hours_primary_care_in_26_European_countries:_an_overview_of_organizational_models L2 - https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/cmaa064 DB - PRIME DP - Unbound Medicine ER -
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