Quelles solutions pour la garde en médecine générale? - KCE

36
• Evaluation : quality of carre
(timeliness – effectiveness - ssafety
–
satisfactionn
– accessibility)- GP’s perception - costs
5.2. Methoddology
First a systemmatic
literature reeview
has been carried out in indexed
literature. Secoond,
complementaary
information fo or specific countries
has
been added froom
the grey literaature.
A common n discussion summmarizes
and comments all findings.
5.2.1. Searcch
in the indexedd
literature
The main MESH
terms used in ccombination
were after-hours care, primary
health care annd
family practicce.
They were subsequently s
adaapted
in
Emtree terms for the search in EMBASE. Th he search strateggies
are
available upon request.
The search date
limit was 19999.
The reason is that initiatives wwere
first
launched in thee
early nineties in Denmark, mid nin neties in the Nethherlands.
The first evaluuations
of these projects were published p in the indexed
literature a few years later.
The following databases
were syystematically
sear rched to January 2011 for
systematic revieews
of studies in MDCR:
• OVID Medline;
• OVID EMBBASE;
• Cochrane eeffective
practice and organization care group.
Inclusion and exclusion criteriia
The inclusion of
papers was based
on:
• the scope oof
the article (cf. SSPICE
description n above);
• the design of the paper (reseearch
article);
• the languagge
(English, Frencch,
Dutch);
Exclusion criterria
were:
• Perspectivee
:
o ED and
hospitals
o Speciffic
populations (paalliative,
psychiatr ric, indigent patients)
and
populaations
with specificc
health problems s (e.g. asthma);
Affter-Hours
Primaary
Care
KCE Reportss
171
• Intervention: care during offi
population survey
on after-hou
• Design: other than research art
• Setting : not inn
Western Europe
• Other languagges
than English,
QQuality
appraisall
TThe
quality appraisal
of the system
the
tool from the DDutch
Cochrane c
aappraisal
and the tables of evidence
55.2.2.
Search iin
the grey litera
Information
from thhe
grey literature
KKingdom,
and Deenmark.
This sel
aavailable
from thhe
indexed liter
ppublished
by Huibbers
et al.
immplemented
a na
ccontinuity
of care
aafterwards
given
BBelgian
health car
A five-step approa
31 ce hours – abseence
of model (ffor
ex
rs care);
ticle (opinions, edditorial);
ean countries;
French or Dutch.
matic reviews hass
been assessed using
collaboration. Thee
results of this qquality
e tables are availaable
upon requestt.
ature
was added for Thhe
Netherlands, UUnited
lection was baseed
on the informmation
ature and on tthe
review previiously
Thesse
3 countries sttand
out as they have
ational reform sincce
a few years too
tackle the probleem
of
during after-hourss
periods. Italy annd
France were aadded
their similarity annd
therefore poteential
relevance tto
the
re system.
ach was used for tthe
analysis of thee
5 countries: