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Continuity of care in after-hours house call medical services: An exploration of follow-up patterns in an Australian context
journal contribution
posted on 2018-06-01, 00:00 authored by Chris O Ifediora, Gary RogersGary RogersRationale, aims and objectives
This study explores the postconsultation follow‐up behaviours of patients who used the Australian after‐hours house‐call (AHHC) medical services. These behaviours provide insights into the nature of the continuity of care (CoC) in the industry and are a measure quality in AHHC service delivery. Understanding the patterns of these CoCs and their predictors will enable stakeholders in the industry, both locally and globally, plan and implement higher quality services.
Methods
This is a cross‐sectional survey of all 10,838 patients who used AHHC during the last week of January 2016. A validated questionnaire was used, distributed through a mix of online and postal questionnaires.
Results
One thousand two hundred twenty‐eight questionnaires were returned (11.3%). Had the AHHC not been available, 38.6% of respondents would have gone to their own general practitioners (GPs), 40.1% to an emergency department (ED), 15.9% to an office‐based after‐hours service, and 5.5% would have done nothing. After the AHHC visits, however, 47.3% followed up with their GPs, 8.4% went to an ED, 4.2% arranged for a further AHHC visit, while 40.0% required no follow‐up.
Patients who required GP follow‐ups were likely to be dissatisfied with aspects of the AHHC care received, while those with no follow‐ups were generally satisfied. Patients ≥65 years were more likely to require no follow‐ups (P < .001) and, if they did, were unlikely to do so with their GPs (P = .04). Where required, follow‐ups for those aged ≤16 years were likely to result in ED attendances (P = .01), while students generally rely on AHHCs for follow‐ups (P = .03). Compared to females, males were likely to rely on their GPs (P = .01), and less likely to go to an ED (P = .01).
Conclusion
Most patients seen by Australian AHHC services either end up requiring no further follow‐up, or do so with their own GPs, with few relying on further AHHC visits for follow‐up. The real reasons for follow‐up differences observed by age and gender may need to be explored further so as to ensure that the AHHC services are better used.
This study explores the postconsultation follow‐up behaviours of patients who used the Australian after‐hours house‐call (AHHC) medical services. These behaviours provide insights into the nature of the continuity of care (CoC) in the industry and are a measure quality in AHHC service delivery. Understanding the patterns of these CoCs and their predictors will enable stakeholders in the industry, both locally and globally, plan and implement higher quality services.
Methods
This is a cross‐sectional survey of all 10,838 patients who used AHHC during the last week of January 2016. A validated questionnaire was used, distributed through a mix of online and postal questionnaires.
Results
One thousand two hundred twenty‐eight questionnaires were returned (11.3%). Had the AHHC not been available, 38.6% of respondents would have gone to their own general practitioners (GPs), 40.1% to an emergency department (ED), 15.9% to an office‐based after‐hours service, and 5.5% would have done nothing. After the AHHC visits, however, 47.3% followed up with their GPs, 8.4% went to an ED, 4.2% arranged for a further AHHC visit, while 40.0% required no follow‐up.
Patients who required GP follow‐ups were likely to be dissatisfied with aspects of the AHHC care received, while those with no follow‐ups were generally satisfied. Patients ≥65 years were more likely to require no follow‐ups (P < .001) and, if they did, were unlikely to do so with their GPs (P = .04). Where required, follow‐ups for those aged ≤16 years were likely to result in ED attendances (P = .01), while students generally rely on AHHCs for follow‐ups (P = .03). Compared to females, males were likely to rely on their GPs (P = .01), and less likely to go to an ED (P = .01).
Conclusion
Most patients seen by Australian AHHC services either end up requiring no further follow‐up, or do so with their own GPs, with few relying on further AHHC visits for follow‐up. The real reasons for follow‐up differences observed by age and gender may need to be explored further so as to ensure that the AHHC services are better used.
History
Journal
Journal of Evaluation in Clinical PracticeVolume
24Issue
3Pagination
514 - 520Publisher
Wiley-Blackwell PublishingLocation
Chichester, Eng.Publisher DOI
ISSN
1356-1294eISSN
1365-2753Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2018, John Wiley & SonsUsage metrics
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No categories selectedKeywords
Science & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesMedical InformaticsMedicine, General & InternalGeneral & Internal Medicineafter-hourscontinuity of caredeputizing servicesfollow-upgeneral practitionershouse callspatientsGENERAL-PRACTICEPATIENT SATISFACTIONEMERGENCYASSOCIATION
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