Quelles solutions pour la garde en médecine générale? - KCE
Quelles solutions pour la garde en médecine générale? - KCE
Quelles solutions pour la garde en médecine générale? - KCE
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<strong>KCE</strong> Reports 1771<br />
Items<br />
Affter-Hours<br />
Primaary<br />
Care<br />
Annual use of the cooperativ ve by pati<strong>en</strong>ts:<br />
There aare<br />
no official data on the use of the cooperratives<br />
by pati<strong>en</strong>ts.<br />
Indicatiion:<br />
Int<strong>en</strong>deed<br />
for urg<strong>en</strong>t help requ uests that cannot wait until the next day<br />
Avai<strong>la</strong>bbility:<br />
Avai<strong>la</strong>bble<br />
daily from 4 p.m. to o 8 a.m. and the <strong>en</strong>tiree<br />
week<strong>en</strong>d and public holidays.<br />
Time frrame<br />
for answering to calls:<br />
The fivve<br />
regions have define ed quality standards with respect to after- hours care including waiting times, the timme<br />
from arrival to the consultation room unntil<br />
doctor<br />
consulttation,<br />
and the time un ntil the doctor arrives aat<br />
a home visit.<br />
As an eexample<br />
the service goals<br />
for The C<strong>en</strong>tral DD<strong>en</strong>mark<br />
Region:<br />
90% off<br />
all telephone calls sh hould be answered by a doctor within 5 minuutes.<br />
Time frrame<br />
for urg<strong>en</strong>t and no on-urg<strong>en</strong>t visits:<br />
Results<br />
As an eexample<br />
the service goals<br />
for The C<strong>en</strong>tral DD<strong>en</strong>mark<br />
Region:<br />
90% off<br />
all pati<strong>en</strong>ts should be e se<strong>en</strong> by a doctor withhin<br />
1 hour after referraal<br />
to the consultation rroom.<br />
90% off<br />
all home visits should d be provided within 3 hours after referral.<br />
Locatioon:<br />
After-hoours<br />
organized in loca al after-hours clinics (ooft<strong>en</strong><br />
in connection witth<br />
local hospitals, but not as an implem<strong>en</strong>teed<br />
part of the hospital organization). The service<br />
thus<br />
functionns<br />
as a gate-keeper or<br />
gate-op<strong>en</strong>er to hosppitals.<br />
Accesss:<br />
With single<br />
regional telephon ne number.<br />
Worklooad<br />
GPs:<br />
The woorkload<br />
varies dep<strong>en</strong>ding<br />
of the region and aage<br />
of the GP. Some GPs are 8-16 hours oon<br />
duty per month but other GPs have a more<br />
important workloadd<br />
(up to 48<br />
hours pper<br />
month).<br />
Servicees:<br />
Telephone<br />
consultations: doc ctors on duty are trainned<br />
g<strong>en</strong>eral practitioneers<br />
who provide telephhone<br />
consultations<br />
Consultations<br />
in local after-hours<br />
clinics (oft<strong>en</strong> in cconnection<br />
with local hhospitals)<br />
Home vvisits<br />
wh<strong>en</strong> needed.<br />
Remarkk:<br />
About half of the contacts c are terminateed<br />
by providing advicee<br />
only (including presscriptions<br />
or referral too<br />
their own doctor thee<br />
following day). In emmerg<strong>en</strong>cy<br />
cases tthey<br />
refer pati<strong>en</strong>ts dire ectly to a hospital.<br />
Staff: OOnly<br />
GPs<br />
In somme<br />
regions there is a <strong>la</strong>ck of trained GP’s ttherefore<br />
other doctors<br />
are allowed to take<br />
shifts but only in thhe<br />
after-hours consulttation<br />
rooms or at home<br />
visits.<br />
Telephone<br />
consultations are e managed by trained GP’s only. Medical sttud<strong>en</strong>ts<br />
can in their <strong>la</strong>sst<br />
year participate to ssome<br />
ext<strong>en</strong>t in after-hours<br />
care (phone connsultations<br />
and home<br />
visits).<br />
Remarkk:<br />
Repres<strong>en</strong>tatives fro om the Association of G<strong>en</strong>eral Practitioners (repres<strong>en</strong>tatives for thhe<br />
after-hours organizzations)<br />
are against the<br />
idea that a nurse shhould<br />
take<br />
care of f the triage.<br />
Logisticc<br />
support:<br />
Only a few GPs use there ow wn car wh<strong>en</strong> on duty. Most GPs have a carr<br />
with chauffeur providded<br />
by the region. Thee<br />
car is an (ordinary) taxi<br />
oft<strong>en</strong> with standarrd<br />
medical<br />
equipmm<strong>en</strong>t<br />
in the trunk.<br />
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