Co-location of out of hours primary care and emergency department in Belgium: patients’ and physicians’ view

Abstract

Background In Belgium, General Practitioner Cooperatives (GPC) aim to improve working conditions for unplanned care and to reduce the number of low acuity emergency visits. Although this system is well organized, the number of low acuity visits does not decrease. Methods We explored the view of patients and physicians on the co-location of a GPC and an emergency service for unplanned care. The study was carried out in a cross section design in primary and emergency care services and included patients and physicians. Main outcome measure was the view of patients and physician on co-location of a GPC and an emergency service. Results 404 patients and 488 physicians participated. 334 (82.7%) of all patients favoured a co-location. The major advantages were fast service (104, 25.7) and adequate referral (54, 13.4%). 237 (74%) of the GPs and 38 (95%) of the emergency physicians were in favour of a co-location. The major advantage was a more adequate referral of patients. 254 (79%) of the GPs and 23 (83%) of the emergency physicians believed that a co-location would lower the workload and waiting time and increase care quality (resp. 251 (78%), 224 (70%) and 37 (93%), 34 (85%). Conclusions To close the expectation gap between GP’s, emergency physicians and to reach for high care quality, information campaigns and development of workflows are indispensable for a successful implementation of a co-location of primary and emergency care.

Non-compliance with a nurse’s advice to visit the primary care provider: an exploratory secondary analysis of the TRIAGE-trial

“…These GPCs operate as walk-in centres for unplanned OOH care, thus offering an alternative for ED visits, and are staffed by the regional GPs. In Belgium, approximately 80 cooperatives have been introduced from 2003 onwards, covering about 70% of the population [ 5 , 6 ] The organisation of these cooperatives improved access to OOH primary care and was associated with an increased use of primary care. However, GPCs did not necessarily lead to a decrease in the workload of EDs [ 7 ] Patients with low-risk complaints, easily treatable by a GP, continue to make emergency visits, as most patients base their decision on previous experience, ease of access, the anticipated waiting time, the relationship with their general practitioner (GP), or the perceived nature of the complaints [ 8 , 9 ] These visits can be a problem because, when EDs are already crowded, they may compromise efficient use of healthcare personnel, infrastructure, and financial resources.…”

The feasibility of teleconsultations in unplanned primary care: a cross section intervention

“…These integrated medical triage protocols 1733-112 are written down in the Belgian Manual for Medical Regulation. (4,5) Each call for a medical care request is classi ed by an operator using the triage protocols, in a certain severity level that corresponds to the appropriate type of regulation. Regulatory resources are resources that can be used to meet patient care needs.…”

Triaging and referring in adjacent general and emergency departments (the TRIAGE trial): A cluster randomised controlled trial

“…Diverting patients in emergency departments to primary care services helps patients to make this choice, but little is known about its safety and effectivity [ 8 – 10 ]. Both patients and physicians in Belgium are in favour of co-locating these services [ 11 ]. Improved access to OOH primary care was associated with increased primary care utilisation but did not necessarily lead to a decrease of workload at the ED [ 9 ].…”