Quelles solutions pour la garde en médecine générale? - KCE

KCE Reports 1771
below. 15 The eevaluation
(see chhapter
6.2) is diff ficult because all centres
differ (e.g. acceessibility,
area, faccilities,
manageme ent plans).
Table 1. Charaacteristics
of the organized duty centres c
Opening:
Week-ends
Opening:
public holidays
Opening:
weekdays
Opening
period
Number of GPs
on duty
Support
Building
Fees
Number of
contacts
Cost
Experimental centrees
: 16 ODC (14
survey participants) )
All open during the
week-ends, All open during weeek-ends,
daytime.
da aytime.
Eight centres also oopen
during the So ometimes till 11 or 122
p.m. (or
WE nights.
even
during nights).
Open in public holidaays:
Op pen in public holiday:
- either period during
the day itself - either e period during the day
(period from 2h to 24h)
itse elf (period from 2h to 224h)
- or begin the evening
before (6 or 8 - or o begin the eveninng
before
p.m.) until the next dday
(until 7 or 8
a.m.)
until
the next day
2 centres open durring
the week’s Brussels:
4 centres opeen
in the
nights
evening
(until 11 or 12 pp.m.)
and
2 centres open during
the
from 4h to 118h/wweek
(mean =
we eekdays as well.
fro om 57h to 98h/week (mean =
48h/week)
69 9h/week)
1 to 5 GPs in the cenntre
and 1 to 10 1 to t 4 GPs in the centree
and 1 to
GPs for home visits.
6 GP for visits (if aapplicable
be ecause some urbaan
ODC
Clerical (secretary) aand/or
logistical
pe erform no visit)
Cle erical (secretary) and/or
driver
(driver) support forr
all except 2 and/or
nurse support forr
all.
centres.
From 0.33 to 6 ETP/ppost.
No support by nurse
Fro om 2 to 8.2 ETP/ centtre.
Renting building for all: local Re enting building to private
authorities, privatee
lessors or les ssors for the majority ( (2 to local
hospital (public or privvate).
authorities
and 2 to hosppital)
Fees reception by the
GP in most Fe ees perception eitherr
by the
centres (8/13), by the
centre for the
other ones.
centre
or by the GP.
For 9 ODC (createed
before june Fo or 8 ODC (createdd
before
2008), 76 797 contacts
in 2008 and 20 008), 63 398 contactss
in 2008
83 976 in 2009.
and
89 417 in 2009.
For 10 ODC in 20009,
total annual
expenditure = € 3 268 149 and
Ce entres in large citiies
: 11
OD DC (but 10 survey
pa articipants)
Fo or 10 ODC in 20009,
total
expenditure
= € 2 701 308 and
Affter-Hours
Primaary
Care
Experimental
centres : 16 ODC (14 Centrres
in large cities : 11
surrvey
participants)
ODC (but 10 survey
particcipants)
recceipts
= € 3 359 068.
FFunding
NIHHDI
and variable addittional
souurces,
including a finanncing
by the
GPPs
themselves.
receippts
= € 2 649 248
22.4.3.
Strengthhs
and weaknessses
of the organnized
duty centrees
system
TThe
person in chaarge
of the ODCs
raised many isssues
(see appenndices
88.3.2,
8.3.3, 8.3. .4 and 8.3.5) thhat
are summarrized
in the folloowing
pparagraphs.
The aadvantages
of ODDCs
underlined byy
the GP organizaations
( see 8.2.1) and byy
the associations
of young GPs (see 8.2.2) have been
aadded.
22.4.3.1.
Strenggths
of the ODCC
system
• Logistics (premises,
call centree);
• Centralised oorganization
(mergge
of geographiccal
areas, some OODCs
share commoon
IT infrastructuree
or telephonists); ;
• Comfort for thhe
GPs (e.g. safeety,
workload, disstinction
between work
and private liffe);
• Advantages ffor
the patient (ee.g.
accessibility, unique number, short
waiting time);
• Quality of the service (telephonnists’
training, callss’
registration) ;
• Collegiality beetween
GPs from the same area;
• Patient educcation
(first linne
versus emeergency
departmments,
•
consultations versus home visits);
Possible netwwork
with other partners (caregivers,
hospitals, local
authorities);
• Quality of caree
when working wwithin
a team, self-evaluation;
• Registration oof
all calls and further
transmission
of information tto
the
patient’s GP,
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