Quelles solutions pour la garde en médecine générale? - KCE

More documents

Recommendations

Info

114 34. Hsu R, Lamert P, Dixon-WWoods M, Kurinczu uk J. Effect of NHHS walk-in centre onn local primary healthcare se ervices: before and after observationnal study. BMJ 20003; 326: 530. 35. Pickin D, OO’Cathain A, Fall M, Morgan A, Ho owe A, Nicholl J. TThe impact of a generral practice coopeerative on acciden nt and emergency services, patient satiisfaction, and GP satisfaction. Fam m Pract 2004; 21: 1180-2. 36. Bunn F, Byyrne G, Kendall SS. Telephone con nsultation and triaage: effects on health care use and ppatient satisfactio on. Cochrane daatabase of Systematicc Reviews. 2004(33). 37. Mark A,Sheperd I. NHS Direect: managing de emand for primaryy are? Int J Health Plannn Manage 2004; 19(1): 79-91. 38. Lattimer V, Turnbull J, Burggess A, Surridge H, Gerard K, Latthlean J, et al. Effect of introduction oof integrated out of hours care inn England: observationnal study. BMJ 20005; 331: 81-4. 39. Munro J, Sampson F, Niccholl J. The imp pact of NHS Direect on the demand foor out-of-hours prrimary and emerg gency care. Br J Gen Pract 2005; 55: 7790-2. 40. Fletcher J, Pickard D, Rosee J, Stewart-Brown S, Wilkinson E, , Brogan C et a. Thee introduction off integrated out-of-hours arrangements in England: a discrete choice experiment of public preferrences for alternative models in health care. Health Expe ect 2006; 9(1): 600-9. 41. Grol R, Gieesen P, Van Uden C. After-hours care c in the Unitedd Kingdom, Denmark, aand the Netherlannds: New models. Health Aff 2006; 25: 1733- 7. 42. Price J, Haaslam J, Cowan JJ. Emerging risks in out-of-hours prrimary care services. CClin Gov 2006; 11( (4): 289-98. 43. Hurst K. BBritish out-of-hourrs primary and co ommunity care: a review of literature. IInt J Health Caree Qual AssurInc Leadersh L Health SServ 2006; 19(1): 42-559. 44. Halter M, MMarlow T, Mohammmed D, Ellison G. G A patient surveyy of out-ofhours caree provided by emeergency care prac ctitioners. BMC EEmerg Med 2007;7. Affter-Hours Primaary Care KCE Reportss 171 45. Richards S, Pouund P, Dickens A, Greco M, Campbbell J. Exploring uusers’ experiences of accessing out-off-hours primary mmedical care servvices. Qual Saf Health Care 2007; 16(6) ): 469-77. 46. A guide to paatient and publicc involvement inn urgent care. 22008. Department of HHealth, UK. 47. Egbunike J, Shhaw C, Bale S, Elwyn G, Edwards A. Understanding patient experiennce of out-of-hours general practitiooner services in SSouth Wales: a qualitattive study. Emergg Med J 2008; 25: 649-54. 48. Turnbull J, Marrtin D, Lattimer VV, Pope C, Cullifford D. Does distance matter? Geograaphical variation in GP out-of-hoours service usee: an observational stuudy. Br J Gen Praact 2008; 58(552): : 417-7. 49. Campbell J, Rooland M, Richardds S, Dickens A, Greco M, Bowwer P. Users’ reports aand evaluations oof out-of-hours heealth care and the UK national quality requirements: a cross sectional sstudy. Br J Gen Pract 2009; 59(558): 88-15. 50. Egbunike J, Shaaw C, Porter A, Button L, Kinnerssley P, Hood K, et al. Streamline triage and manage user expectations: : lessons from a study out-of-hours servvices. Br J Gen PPract 2010; 60: 83--97. 51. Kelly M, Egbunike J, Kinnersley PP, Hood K, Owenn-Jones E, Buttonn L, et al. Delays in ressponse and triagee times reduce ppatient satisfactionn and enablement afteer using out-of-hours services. Famm Pract 2010; 27: 652- 63. 52. Kinnersley P, Eggbunike J, Kelly MM, Hood K, Owen-Jones E, Button LLA, et al. The need to improve the interfface between in-hhours and out-ofhours GP care, and beetween out-of-houurs care and self-care. Fam Pract 22010; 27(6): 664-72. 53. Carr-Bains S, Nightingale A, BBallard K. Patients’ experiencess and satisfaction withh out-of-hours GGP home visitingg provided by a GP cooperative. Fammily Practice 20111; 28: 88-92.
KCE Reports 1771 8.4.3. After-hhours care in Deenmark Items Affter-Hours Primaary Care Expert(s) interviewwed Researrch Unit for General Practice, University of AAarhus, Denmark: Lone FFlarup l.flarup@alm.au u.dk tel: +45 8942 6159 Morten Bondo Christensen, mbc@alm.au.dk m Literature base Nationaal and international pu ublications and websitees on the topic of afterr- hours care in Denmmark Characteristics off the health Danish healthcare is both tax x funded and almost eentirely publicly provideed system with relevaance to Health care spending per cap pita: $3,512 after-hours servicces Coveraage is universal and co ompulsory. All those rregistered as residentts in Denmark are entitled to health care thaat is largely free at thee point of use. Equal access to healthccare for all 5.56 million n citizens. A majoor national administrat tive reform in 2007 reeduced the number off communities from 2271 to 98 and 13 counties to five regions. After the reform health care is financeed by the regions throu ugh four economical ssources: a general finaancial contribution fromm the central governmment, a basic contribution from the communitties within the reggion, an activity depen nded contribution fromm the central governmment and finally a cenntrally collected tax seet at 8 percent of taxaable income are earmmarked for health. Public eexpenditure accounted for around 82 percent of total health expeenditure in 2005. The five regions are respons sible for providing hosspital care, and own and run the hospitals. The regions also payss activity depended finnancial contributions tto general and speecialist practice, physi iotherapy and pharmaaceuticals. The 988 municipalities are re esponsible for most oof the nursing homess, home nursing care, , health visitors, municipal dentists (childreen’s dentists and homme dental servicees for disabled people e), school health servvices, home help, andd the treatment of alccoholics and drug adddicts. Healthcare is organized in such a way that responsibility for services provided lies within thhe lowest possible addministrative level, ussually the county (noww region) councils (ssubsidiarity). Since 19970, most decisioons regarding the form and content of healthh care activity have been made at county (noow region) and municipal level. The reggions are given wide powers p to make organnizational decisions forr health services according to their own polittical decisions and possibilities. Roughlly two in five citizens have complementary private insurance as a supplement to the sservices that are not ffully covered by the sttate, such as dentist aand some sorts off physiotherapy, and around a 5% of all citizens has a private insurrance that covers acceess to treatments at prrivate hospitals. In adddition, some companiees provide health iinsurance for their em mployees. GPs arre organized as self-e employed doctors in pprivate clinics. GPs, of which there are rougghly 3,600, operate wwholly within the public healthcare system, acting as gatekeeepers to specialists an nd hospitals. Numbeer of practicing physicians per 1000 populatiion = 3.2 (2006) Patientts must register with a GP of their choice praactising within 15 km oof their home. They haave the right to changee their GP, but in pracctice this rarely happenns. Each GGP has about 1,600 registered patients. The number of practising GP Ps in each region is suubject to collective agreeements negotiated between the regions annd the GP section of thhe Danish Medical Asssociation. The ressult is an even distribu ution across the populaation. Compaared to some neighbo ouring countries, the Danish service is chaaracterized by a high number of telephonee contacts per doctorr per hour (> 15 conttacts) and relativeely low cost per contac ct. Total coosts per person are re elatively high, though, due to a high numberr of contacts per inhabbitant (535 per 1000 peer year). In contrrast, the use of emerg gency departments is rrelatively low. After-hoours care is regionally y organized as an econnomically agreement bbetween the GP’s andd the regions. All GP’ss under the age of 60 aare obligated to particiipate. Situation before reeform Before the reform of January y 1992 basically the GGP’s were responsiblee for their own patientts 24/7/365. The docttor had to manage thee patient contact by hhim selves mainly without any assistanc ce. In villages and ruraal areas, between three and 10 doctors co-ooperated to provide ouut-of-hours cover accoording to a rota. Telephhone calls from paatients were answere ed by the GPs or their spouses. A large ammount of patients’ calls ended with telephoone advice but homee visits were the mostt common contactt and surgery consulta ations were kept to a mminimum. In largee towns, a locally orga anized rota system proovided after-hours caree for the registered paatients of 20 to 100 GPPs. Doctors’ duty sessions lasted eight to 122 hours. In somee of the largest towns some rota groups contracted with a centraal service with receptioonists to handle the paatients’ calls but the mmost common telephonne contact was annswered by the rota group g doctors themseelves. There were emeergency consultation centres, but these weere rarely used; 90–995% of patients receivved home visits. Results 115
Page 1 and 2:
KCE REPORTS 2011 171B QUELLLES SOOL
Page 3:
Contrôle Direction Contact Comm mi
Page 6 and 7:
COLOPHOON Titre : Auteurs : Experts
Page 9 and 10:
KCE Reports 1771B PRÉFFACE Il y a
Page 11 and 12:
KCE Reports 1771B Obstacles liéés
Page 13 and 14:
KCE Reports 1771B Autres alternnati
Page 15 and 16:
KCE Reports 1771B Garddes en médec
Page 17 and 18:
KCE Reports 1771B SYNTTHÈSE Garde
Page 19 and 20:
KCE Reports 1771B 1.3.2. Chargees d
Page 21 and 22:
KCE Reports 1771B La plupart des é
Page 23 and 24:
KCE Reports 1771B n'est pas le cass
Page 25 and 26:
KCE Reports 1771B PROCESSUS PROCÉD
Page 27 and 28:
KCE Reports 1771 SCIENTIFIC RREPOR
Page 29 and 30:
KCE Reports 171 Affter-Hours Primaa
Page 31 and 32:
KCE Reports 171 Affter-Hours Primaa
Page 33 and 34:
KCE Reports 1771 LIST OF FFIGURES L
Page 35 and 36:
KCE Reports 1771 LIST OF AABBREVIAT
Page 37 and 38:
KCE Reports 1771 Affter-Hours Prima
Page 39 and 40:
KCE Reports 1771 1.1.3. Initial The
Page 41 and 42:
KCE Reports 1771 below. 15 The eeva
Page 43 and 44:
KCE Reports 1771 2.6. Uniquee call
Page 45 and 46:
KCE Reports 1771 • Advising thhe
Page 47 and 48:
KCE Reports 1771 regarding tthe org
Page 49 and 50:
KCE Reports 1771 • The GP By join
Page 51 and 52:
KCE Reports 1771 sanctioning coompe
Page 53 and 54:
KCE Reports 1771 contacts and too s
Page 55 and 56:
KCE Reports 1771 Table 3: Numbber o
Page 57 and 58:
KCE Reports 1771 4.2.2.3. Limmitati
Page 59 and 60:
KCE Reports 1771 When looking at ag
Page 61 and 62:
KCE Reports 1771 4.3.2. Type of are
Page 63 and 64:
KCE Reports 1771 1.a.Use oof search
Page 65 and 66:
KCE Reports 1771 • perceived work
Page 67 and 68:
KCE Reports 1771 Continuity of c as
Page 69 and 70:
KCE Reports 1771 • The safetyy of
Page 71 and 72:
KCE Reports 1771 5.4.4. Financial i
Page 73 and 74:
KCE Reports 1771 the ambulance serv
Page 75 and 76:
KCE Reports 1771 5.4.9.1. Thee Neth
Page 77 and 78:
KCE Reports 1771 the patient’s ne
Page 79 and 80:
KCE Reports 1771 • To assesss the
Page 81 and 82:
KCE Reports 1771 6.1.1.1. Thee Neth
Page 83 and 84:
KCE Reports 1771 between € 14 inn
Page 85 and 86:
KCE Reports 1771 Table 16 : Disstri
Page 87 and 88:
KCE Reports 1771 The NIHDI tablees
Page 89 and 90: KCE Reports 1771 Some demograaphic
Page 91 and 92: KCE Reports 1771 In the same wway,
Page 93 and 94: KCE Reports 1771 8. APPEENDICES 8.1
Page 95 and 96: KCE Reports 1771 • A logistic o c
Page 97 and 98: KCE Reports 1771 • The after-hhou
Page 99 and 100: KCE Reports 1771 o Decreaase of GP
Page 101 and 102: KCE Reports 1771 o en terrme de san
Page 103 and 104: KCE Reports 1771 Place, Populattion
Page 105 and 106: KCE Reports 1771 • Eviter les pat
Page 107 and 108: KCE Reports 1771 Nombre de vissites
Page 109 and 110: KCE Reports 1771 • Prévoir dees
Page 111 and 112: KCE Reports 1771 appelss, délais e
Page 113 and 114: KCE Reports 1771 8.3.4.4. Othhers T
Page 115 and 116: KCE Reports 1771 • One difficuult
Page 117 and 118: KCE Reports 1771 personnes (réggio
Page 119 and 120: KCE Reports 1771 • Réponse à un
Page 121 and 122: KCE Reports 1771 overchargee of som
Page 123 and 124: KCE Reports 1771 Items System refor
Page 125 and 126: KCE Reports 1771 Items Who does the
Page 127 and 128: KCE Reports 1771 8.4.1.1. Weebsites
Page 129 and 130: KCE Reports 1771 study of twwo inte
Page 131 and 132: KCE Reports 1771 Items Main drivers
Page 133 and 134: KCE Reports 1771 Items Affter-Hours
Page 135 and 136: KCE Reports 1771 Items Critical suc
Page 137 and 138: KCE Reports 1771 Items Suggestions
Page 139: KCE Reports 1771 10. Dale J, Croouc
Page 147 and 148: KCE Reports 1771 Items Number of ac
Page 151 and 152: KCE Reports 1771 8.4.5. After-hhour
Page 155 and 156: KCE Reports 1771 INAMI/RIZIV/NIHDI
Page 157 and 158: KCE Reports 1771 o Avec l Il y a de
Page 159 and 160: KCE Reports 1771 compléter les sse
Page 161 and 162: KCE Reports 1771 des accords de soi
Page 163 and 164: KCE Reports 1771 qui seerait de gar
Page 165 and 166: KCE Reports 1771 8.5.2.2. Norrmes e
Page 167 and 168: KCE Reports 1771 • Les norme Deux
Page 169 and 170: KCE Reports 1771 S’il ne particip
Page 171 and 172: KCE Reports 1771 Des deux dispoosit
Page 173 and 174: KCE Reports 1771 L’article 9, §
Page 175 and 176: KCE Reports 1771 o En ou grave. A c
Page 177 and 178: KCE Reports 1771 L’on envisage s
Page 179 and 180: KCE Reports 1771 Si le conseil nnat
Page 181 and 182: KCE Reports 1771 Affter-Hours Prima
Page 183 and 184: KCE Reports 1771 patiënten. Zoa hi
Page 185 and 186: KCE Reports 1771 o De aaangestelde
Page 187 and 188: KCE Reports 1771 De standaardlijs b
Page 189 and 190: KCE Reports 1771 de 1733-centrrales
Page 191 and 192:
KCE Reports 1771 worden in een ziek
Page 193 and 194:
KCE Reports 1771 waarvan de veerant
Page 195 and 196:
KCE Reports 1771 Affter-Hours Prima
Page 197 and 198:
KCE Reports 1771 De arts die dooor
Page 199 and 200:
KCE Reports 1771 rétablissemment d
Page 201 and 202:
KCE Reports 1771 peuplée et une zo
Page 203 and 204:
KCE Reports 1771 Code de nomenclatu
Page 205 and 206:
KCE Reports 1771 8.6.3.2. Nummber o
Page 207 and 208:
KCE Reports 1771 Number of outt-of-
Page 209 and 210:
KCE Reports 1771 8.7. Appenddices:
Page 211 and 212:
KCE Reports 1771 8.7.2.2. Thirrd ye
Page 213 and 214:
KCE Reports 1771 9. REFEERENCES 1.
Page 215 and 216:
KCE Reports 1771 38. Pickin DMM, O'
Page 217 and 218:
KCE Reports 1771 79. Thompsoon F, G
Page 219 and 220:
KCE Reports 1771 121. Arrêté roya
Page 221:
KCE Reports 1771 Tijdschrifft van d
show all

Quelles solutions pour la garde en médecine générale? - KCE

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?