Out-of-hours primary care services: Demands and patient referral patterns in a Veneto region (Italy) Local Health Authority

Abstract

Our study shows that OOH services meet composite and variously expressed demands. The determining factors associated with cases referred to other health care services should be considered when designing clinical pathways in order to ensure a continuity of care. The unwarranted variability in OOH physicians' performance needs to be addressed.

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

“…This tendency was confirmed in the multivariate analysis. 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).…”

“…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.…”

“…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. An Italian study that investigated telephone triage quality confirmed the importance of these courses and outlined the need for improvement in this area (20).Indeed, the correct use of TA can decrease the medical workload by nearly 40% (4, 10); this result is welcomed by patients (3,8,10), and it appeared safe when it was conducted by trained operators (9).Considering the overall outcomes, our analysis outlined a lower use of outpatient and home visits than that outlined in another national study (17), highlighting to the greater number of TA outcomes.…”

“…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.…”

“…The greater use of the service by women was described previously in studies from other countries (2,5).Men were previously shown to self-refer themselves to the ED (19).In contrast, this lack of difference in gender was in opposition with the results of other studies that outlined that men were more frequently referred to the ED or to outpatient visits than women (17).…”