Prioritization and management of calls from older people to GP out-of-hours services.
GP cooperative
GP out-of-hours service
general practice
older people
telephone triage
Journal
International journal for quality in health care : journal of the International Society for Quality in Health Care
ISSN: 1464-3677
Titre abrégé: Int J Qual Health Care
Pays: England
ID NLM: 9434628
Informations de publication
Date de publication:
22 Feb 2021
22 Feb 2021
Historique:
received:
13
10
2020
revised:
18
01
2021
accepted:
02
02
2021
pubmed:
3
2
2021
medline:
29
7
2021
entrez:
2
2
2021
Statut:
ppublish
Résumé
Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.
Sections du résumé
BACKGROUND
BACKGROUND
Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision.
OBJECTIVE
OBJECTIVE
The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland.
METHODS
METHODS
An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software.
RESULTS
RESULTS
Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care.
CONCLUSION
CONCLUSIONS
Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.
Identifiants
pubmed: 33528500
pii: 6126507
doi: 10.1093/intqhc/mzab021
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.