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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40<br />
• De<strong>la</strong>y befoore<br />
home visit: d<br />
de<strong>la</strong>y seems<br />
reasonable<br />
unreasonable)<br />
•<br />
satisfaction<br />
versus us<br />
exceeds t<br />
cooperative<br />
A U.K. stu<br />
calls answe<br />
home visits<br />
• However d<br />
comp<strong>la</strong>int r<br />
Solutions try<br />
satisfaction:<br />
• Setting and<br />
delivery (e<br />
43, 5<br />
context.<br />
• In some co<br />
to get to th<br />
• Accessibilit<br />
Pati<strong>en</strong>ts who at<br />
because of :<br />
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during regu<br />
• Opportunity<br />
• Less anxie<br />
However few<br />
transport is a cr<br />
• Feeling too<br />
• Having oth<br />
• Difficulty to<br />
• Lacking tra<br />
34 . This exp<br />
n level with the<br />
ual GP 34 or GP<br />
he target time o<br />
es. 60<br />
dy found that “ex<br />
ered within 30 se<br />
s < 1 hour and tre<br />
de<strong>la</strong>y before diag<br />
reported to the pro<br />
to short<strong>en</strong> the<br />
d communicating<br />
e.g. information<br />
59<br />
ountries, doctors u<br />
e pati<strong>en</strong>t immedia<br />
ty of the consultat<br />
tt<strong>en</strong>ded the prima<br />
ing time (more co<br />
u<strong>la</strong>r hours!) 61<br />
dissatisfaction is<br />
e (expect a<br />
pectation can e<br />
AH care provide<br />
P cooperative<br />
y of having face-to<br />
ety (because of les<br />
pati<strong>en</strong>ts accepte<br />
rucial issue for tha<br />
o ill to travel or chi<br />
er dep<strong>en</strong>d<strong>en</strong>ts to<br />
o travel to an unkn<br />
ansportation/costs<br />
46 .<br />
of 6 hours for<br />
xcell<strong>en</strong>t care” mea<br />
ec, call-back within<br />
atm<strong>en</strong>t c<strong>en</strong>tre wa<br />
gnosis is a comm<br />
ovider of indemnit<br />
e de<strong>la</strong>y and/or<br />
g realistic targets<br />
about waiting tim<br />
use the bus <strong>la</strong>ne,<br />
ately in life-threate<br />
tion c<strong>en</strong>tre.<br />
ary care c<strong>en</strong>tre we<br />
onv<strong>en</strong>i<strong>en</strong>t than be<br />
o-face consultatio<br />
ss waiting time) 61<br />
ed a consultatio<br />
35, 51, 53, 62<br />
at model<br />
ildr<strong>en</strong> too ill to be<br />
care for; 61<br />
now area; 61<br />
s of travelling; 61<br />
frequ<strong>en</strong>t ev<strong>en</strong> w<br />
faster respons<br />
exp<strong>la</strong>in a lower<br />
ed by deputising<br />
This de<strong>la</strong>y som<br />
non-urg<strong>en</strong>t visits<br />
ans for 50% of th<br />
n 20 min, waiting<br />
aiting times < 20 m<br />
mon reason for c<br />
ty 56 .<br />
increase the<br />
in re<strong>la</strong>tion to he<br />
me) is important<br />
sir<strong>en</strong>s and f<strong>la</strong>shin<br />
<strong>en</strong>ing comp<strong>la</strong>ints. 3<br />
ere g<strong>en</strong>erally satis<br />
eing se<strong>en</strong> at the<br />
ons; 61<br />
on at the c<strong>en</strong>tre<br />
2<br />
. Pati<strong>en</strong>ts quote n<br />
easily managed; 6<br />
wh<strong>en</strong> the<br />
se was<br />
pati<strong>en</strong>t<br />
service<br />
metimes<br />
s in UK<br />
he users<br />
time for<br />
min. 59<br />
c<strong>la</strong>im or<br />
pati<strong>en</strong>t’s<br />
ealthcare<br />
t in this<br />
ng lights<br />
35<br />
46, 61<br />
sfied<br />
surgery<br />
e 46 . The<br />
notably:<br />
61<br />
• Travel dista<br />
ance; 53<br />
Affter-Hours<br />
Primaary<br />
Care<br />
• L<strong>en</strong>gth of timme<br />
from first coontact<br />
to <strong>en</strong>d off<br />
care (pharmaciist<br />
or<br />
hospital); 61<br />
• Security or sa<br />
TThe<br />
accessibility o<br />
sshows<br />
a geograph<br />
ppati<strong>en</strong>ts<br />
who live<br />
aand<br />
in rural areas<br />
aareas.<br />
c<br />
w<br />
•<br />
C<br />
•<br />
•<br />
•<br />
G<br />
p<br />
te<br />
•<br />
63 Another s<br />
consultation at the<br />
with female g<strong>en</strong>de<br />
• Communicatio<br />
Communication is<br />
• Satisfaction a<br />
several autho<br />
• Dissatisfaction<br />
to describe s<br />
speaking peo<br />
waste the doc<br />
and attitude<br />
consultation 44<br />
afety in the car par<br />
of the consultatio<br />
hical variation in A<br />
at a great distanc<br />
s versus higher ca<br />
study also found<br />
e GP c<strong>en</strong>tre with a<br />
er.<br />
• Telephone tri<br />
skills to crea<br />
training in pa<br />
advising and<br />
like reassuran<br />
talk to a docto<br />
consultation.<br />
of all calls wa<br />
positive corre<br />
and the qualit<br />
Good communica<br />
pati<strong>en</strong>ts’ expecta<br />
echniques of activ<br />
• Continuity of c<br />
64<br />
on<br />
sues are sources<br />
about the attitude<br />
35, 48, 52, 55, 60, 62<br />
ors.<br />
n is re<strong>la</strong>ted to se<br />
symptoms accurat<br />
ople, par<strong>en</strong>ts of<br />
ctor’s time, docto<br />
e of the doct<br />
4, 53<br />
; uncertainties<br />
age is a very co<br />
ate a fri<strong>en</strong>dly and<br />
ti<strong>en</strong>t-c<strong>en</strong>tred com<br />
structuring call. 65<br />
nce, care expecta<br />
or. 55, 66 on c<strong>en</strong>tre is an eq<br />
AH service use, w<br />
ce from the prima<br />
all rates from pat<br />
a decrease likeli<br />
an increased dista<br />
of satisfaction or<br />
e of health profe<br />
everal issues : diff<br />
tely over the pho<br />
childr<strong>en</strong>, elders.<br />
r in a hurry or dis<br />
tor<br />
Moreover,<br />
In 17 AH c<strong>en</strong>tres<br />
as 201 sec (157 –<br />
e<strong>la</strong>tion betwe<strong>en</strong> th<br />
ty of communicatio<br />
ation skills are<br />
ations, concerns<br />
ve list<strong>en</strong>ing, summ<br />
care<br />
56 ; informatio<br />
about respect of c<br />
omplex procedure<br />
d reassuring clim<br />
mmunication with<br />
More att<strong>en</strong>tion sh<br />
ancy, de<strong>la</strong>y of ca<br />
, they need suffic<br />
s in the Nether<strong>la</strong>n<br />
– 267 sec) and th<br />
he l<strong>en</strong>gth of the t<br />
on. 65<br />
quity concern. A<br />
with lower call rat<br />
ary care c<strong>en</strong>tre (><br />
i<strong>en</strong>ts living in dep<br />
hood of a face-to<br />
ance to the c<strong>en</strong>tre<br />
dissatisfaction :<br />
essionals is quote<br />
fficulties for the p<br />
one (mainly not n<br />
..)<br />
recomm<strong>en</strong>ded:<br />
and knowledge<br />
marising and chec<br />
55 ; feeling that<br />
sinterested 55 ; rude<br />
on provision d<br />
confid<strong>en</strong>tiality. 49<br />
e that requires sp<br />
mate. 53 study<br />
es by<br />
>5km)<br />
prived<br />
o-face<br />
e and<br />
ed by<br />
ati<strong>en</strong>t<br />
native<br />
they<br />
<strong>en</strong>ess<br />
during<br />
pecific<br />
Triagists need<br />
active list<strong>en</strong>ing, aactive<br />
hould be paid to isssues<br />
are or the possibility<br />
to<br />
i<strong>en</strong>t time for telepphone<br />
nds, the mean duration<br />
here was a significcantly<br />
telephone consultation<br />
ackwnowledgingg<br />
the<br />
e of their conddition,<br />
47, 55<br />
cking.<br />
rks. 53<br />
<strong>KCE</strong> Reportss<br />
171
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