Diagnostic scope in out-of-hours primary care services in eight European countries: an observational study

Abstract

BackgroundIn previous years, out- of-hours primary care has been organised in large-scale organisations in many countries. This may have lowered the threshold for many patients to present health problems at nights and during the weekend. Comparisons of out-of-hours care between countries require internationally comparable figures on symptoms and diagnoses, which were not available. This study aimed to describe the symptoms and diagnoses in out-of-hours primary care services in regions in eight European countries.MethodsWe conducted a retrospective observational study based on medical records from out-of-hours primary care services in Belgium, Denmark, Germany, the Netherlands, Norway, Slovenia, Spain, and Switzerland. We aimed to include data on 1000 initial contacts from up to three organisations per country. Excluded were contacts with an administrative reason. The International Classification for Primary Care (ICPC) was used to categorise symptoms and diagnoses. In two countries (Slovenia and Spain) ICD10 codes were translated into ICPC codes.ResultsThe age distribution of patients showed a high consistency across countries, while the percentage of males varied from 33.7% to 48.3%. The ICPC categories that were used most frequently concerned: chapter A 'general and unspecified symptoms' (mean 13.2%), chapter R 'respiratory' (mean 20.4%), chapter L 'musculoskeletal' (mean 15.0%), chapter S 'skin' (mean 12.5%), and chapter D 'digestive' (mean 11.6%). So, relatively high numbers of patients presenting with infectious diseases or acute pain related syndromes. This was largely consistent across age groups, but in some age groups chapter H ('ear problems'), chapter L ('musculoskeletal') and chapter K ('cardiovascular') were frequently used. Acute life-threatening problems had a low incidence.ConclusionsThis international study suggested a highly similar diagnostic scope in out-of-hours primary care services. The incidence rates of acute life-threatening health problems were low in all countries.

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

“…These remarks are in agreement with statistics on the higher share of paediatric ED visits for minor clinical problems (11) and with the findings from Buja et al, who conducted a study on out-of-hours primary care in Veneto (17). In summary, these interesting agerelated observations were consistent with both national (17) and international studies (18). Based on these findings, the ASL MI1 started a working group, including family paediatricians and hospital specialists, in order to develop parents-targeted information programmes.…”

“…The main reasons for calling, i.e., gastrointestinal symptoms, respiratory symptoms and pain, did not differ from those outlined in previous studies (17,18).However, we observed a large portion of calls regarding sensory organ symptoms. The analysis of the call reasons and the wide use of TA in 2013 led to the implementation of training courses regarding telephone triage techniques.…”

“…Our classification is in accordance with similar international studies (17)(18)(19).Moreover, in our analysis, we considered a three-month period. Consequently, the retrieved data could have varied with respect to the season.…”

Parents’ knowledge, attitudes, and practice in childhood fever: an internet-based survey

“…However, reconsultation within the same illness episode is common, especially when fever persists. 3 Known factors contributing to these (re)consultations are lack of knowledge among parents, anxiety about fever, and experience of inconsistencies in the approach of different healthcare professionals. 4 This may lead to parental uncertainty, frustration, dissatisfaction with care, and incorrect assumptions about fever in children.…”

Aspects Of Medical Care Provision By Out-Of-Hours Service At PI “Centro Poliklinika“

“…Scholarly sources, providing precise causes (the symptoms and diagnoses) of patient seeking for care at primary personal health care institutions (hereinafter -PPHCI) after office hours are rather limited, although the demand for health services of this category has increased within a few years worldwide [5].…”