Analysis of users and reasons for use of a physician-on-call service in an Italian local health unit

Colombo, Alessandra; Bert, Fabrizio; Camussi, Elisa; Gualano, Maria Rosaria; Arensi, Domenico; Castaldo, Domenico; Siliquini, Roberta; Pirola, Maria Elena

doi:10.1093/fampra/cmw089

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Recently, several countries have developed after-hours house call (AHHC) medical services or out-of-hours services (OOH) to solve the problems of excessive ED visits and ambulance use [3]. Under the AHHC services, physicians visit patients in their houses after hours, thereby reducing the number of ambulance dispatches and ED visits [4][5][6][7][8].…”

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confidence: 99%

Pre- and Post-home Visit Behaviors using an after-hours House Call (AHHC) Medical Services: A Questionnaire-based Survey in Tokyo, Japan

Inokuchi¹,

Morita²,

Jin³

et al. 2021

Preprint

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Background: To reduce the burden caused by emergency department (ED) visits and ambulance use, after-hours house call (AHHC) medical services have been implemented. Examining the pre-and post-home visit behaviors of those who use AHHC medical services, stratified by age and illness severity, may help determine the populations these services should target effectively to reduce ED visits and ambulance use.Methods: This questionnaire-based study used data from anonymized medical records and internet-based questionnaires completed by patients who used AHHC medical services in Tokyo, Japan, between January 1 and December 31, 2019. The questionnaire consisted of two questions: what action would the patient have taken in the absence of AHHC services, and what action was taken within three days following the use of the AHHC services.Results: Of the 15,787 patients who used AHHC medical services during the study period, 2,128 completed the questionnaire (13.5% response rate). Individuals aged <15 years and 16–64 years were the most common users of AHHC services (≤15 years, 71.4%; 16–64 years, 26.8%). Before using the AHHC service, the majority of patients in each patient age group would have visited the ED if the AHHC service had not been available (≤15 years, 47.8%; 16–64 years, 42.8%; ≥65 years, 43.6%), and the proportion of patients originally planning to call an ambulance was higher among those in higher age groups (≤15 years, 1.1%; 16–64 years, 6.0%; ≥65 years, 20.5%). After using AHHC services, the majority of patients (68.1%) did not visit a hospital within three days, but the proportion of patients who visited an ED and called an ambulance within that time increased as their illness severity increased.Conclusions: Increasing AHHC medical services awareness among older adults and encouraging repeated use of AHHC services for patients with severe illnesses may help reduce ED visits and ambulance use.

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Section: Introductionmentioning

confidence: 99%

Pre- and Post-home Visit Behaviors using an after-hours House Call (AHHC) Medical Services: A Questionnaire-based Survey in Tokyo, Japan

Inokuchi¹,

Morita²,

Jin³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

Pre- and post-home visit behaviors after using after-hours house call (AHHC) medical services: a questionnaire-based survey in Tokyo, Japan

et al. 2021

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Background After-hours house call (AHHC) medical services have been implemented in Japan to reduce ambulance use, as well as overcrowding at the emergency department (ED). Examining the pre-and post-home visit behaviors of those using AHHC medical services will provide insights into the usefulness of these services and help develop strategies to reduce ED visits and ambulance use further. Methods This questionnaire-based study used data from anonymized medical records and internet-based questionnaires completed by patients who used AHHC medical services in Tokyo, Japan, between January 1 and December 31, 2019. The questionnaire comprised two questions: (1) What action would the patient have taken in the absence of AHHC services and (2) what action was taken within 3 days following the use of the AHHC services. In addition, following home consultations, AHHC doctors classified the patient’s illness severity as mild (treatable with over-the-counter medications), moderate (requires hospital or clinic visit), or severe (requires ambulance transportation). Results Of the 15,787 patients who used AHHC medical services during the study period, 2128 completed the questionnaire (13.5% response rate). Individuals aged ≤15 years and 16–64 years were the most common users of AHHC services (≤15 years, 71.4%; 16–64 years, 26.8%). Before using the AHHC service, 46.4% of the total respondents reported that they would have visited an ED had AHHC services not been available (≤15 years, 47.8%; 16–64 years, 42.8%; ≥65 years, 43.6%). The proportion of patients originally planning to call an ambulance was higher among those in the older age groups (≤15 years, 1.1%; 16–64 years, 6.0%; ≥65 years, 20.5%). After using the AHHC services, most patients (68.1%) did not visit a hospital within 3 days; however, the proportion of patients who visited an ED and called an ambulance within 3 days increased with the severity of illness. Conclusions Increasing AHHC medical services awareness among older adults and patients assessed as having severe illnesses regularly availing of AHHC services may help reduce ED visits and ambulance use.

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諸外国における時間外往診体制の現状とアウトカム評価に関するスコーピングレビュー

Morita¹,

Inokuchi²,

Jin³

et al. 2022

An Official Journal of the Japan Primary Care Association

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Introduction:We performed a scoping review of after-hours primary care to examine delivery models of afterhours house calls and their use, and conducted outcome evaluation studies of after-hours house calls. Methods: PubMed, Embase, Google Scholar, and Ichuu-shi were used to identify studies published between 2000 and 2021. We selected studies that explained the after-hours house call system or studies that included outcome evaluation. Results:We included 109 studies. The system of after-hours house calls varied in each country. There were one to four research reports on the actual situation of after-hours house calls in each country; however, there were no nationwide reports in Japan. After-hours house calls accounted for the lowest proportion of afterhours care. Only observational studies were found for the impacts of satisfaction and utilization of emergency department services as outcome evaluations for after-hours house-call services. Conclusion: Further research on the after-hours care system is needed, and further discussions based on the results of the study are required.

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Analysis of users and reasons for use of a physician-on-call service in an Italian local health unit

Abstract: Background: In recent years, several countries have proposed changes to primary care organization.

Cited by 3 publications

References 17 publications

Pre- and Post-home Visit Behaviors using an after-hours House Call (AHHC) Medical Services: A Questionnaire-based Survey in Tokyo, Japan

Pre- and Post-home Visit Behaviors using an after-hours House Call (AHHC) Medical Services: A Questionnaire-based Survey in Tokyo, Japan

Pre- and post-home visit behaviors after using after-hours house call (AHHC) medical services: a questionnaire-based survey in Tokyo, Japan

諸外国における時間外往診体制の現状とアウトカム評価に関するスコーピングレビュー

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