Objective: To determine GPs' access to diagnostic tests (medical imaging, laboratory tests, and point-of-care tests) during GP out-of-hours care in the Netherlands and to assess whether access differs between services located adjacent to or separate from an Accident and Emergency (A&E) department.
Design: Cross-sectional survey.
Method: In 2014 we invited all GP out-of-hours services in the Netherlands to participate in a survey on GPs' access to diagnostic tests in Dutch GP out-of-hours services.
Results: 117 GP out-of-hours services participated in the survey; response rate 100%. Although access to diagnostic tests during GP out-of-hours care varied across services, overall there was limited access. Electrocardiography was available in 26% (30/117) of all services, and conventional radiography in 19% (22/117). Access to various types of laboratory tests ranged between 37% (43/117) and 65% (76/117). All services had glucose point-of-care tests and urine dipstick tests available. We observed no relevant differences in access to in-house diagnostic tests between services adjacent to or separate from an A&E department. More than half (56%) of out-of-hours services expressed plans to expand their diagnostic facilities.
Conclusion: GPs in the Netherlands have limited and varying access to diagnostic tests in GP out-of-hours services. GPs working in out-of-hours services adjacent to A&E departments do not have wider access to diagnostic tests than GPs working at a separate location. With current developments towards joint organisation structures of GP out-of-hours services and A&E departments in the Netherlands, the organisation of diagnostic facilities within out-of-hours care may be subject of debate.
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Antibiotics (Basel)
January 2025
School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff CF10 3NB, UK.
Background/objectives: The rapid spread of antimicrobial resistance (AMR) presents a critical threat to global health. Primary care plays a significant role in this crisis, with oral antibacterial drugs among the most prescribed medications. Antibacterial prescribing rates are often high and complicated in out-of-hours (OOH) services, including weekdays outside regular hours, weekends, and holidays, potentially exacerbating AMR.
View Article and Find Full Text PDFEmerg Med Australas
February 2025
National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.
Objectives: To establish the determinants of death in hospital for patients with moderate to severe traumatic brain injury (TBI) in Australia.
Design, Setting, Participants: Retrospective analysis of Australia New Zealand Trauma Registry (ANZTR) data. Cases were included if they presented to a participating hospital between 1 July 2015 and 30 June 2020 and had an Abbreviated Injury Severity (AIS) score - head greater than 2.
J Clin Nurs
January 2025
University of Auckland, Auckland, New Zealand.
Aim: To explore the role of nurse practitioners (NPs) in delivering models of acute and urgent care in local communities informing the development of NPs as a solution to providing sustainable and effective healthcare in these settings.
Design: Descriptive qualitative multicase study.
Methods: The study population comprised NPs, clinic managers and general practitioners from NP-led acute and urgent care clinics across urban and rural Aotearoa New Zealand.
Br J Gen Pract
January 2025
University of Aberdeen, Health Services Research Unit, Aberdeen, United Kingdom.
Background: The challenges of recruiting and retaining rural GPs are well described. UK data suggests high levels of burnout, characterised by detachment, exhaustion and cynicism, plays a role in GP turnover. The contrast is engagement with work.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
Background: e-Consultations, defined as asynchronous text-based messaging, have transformed how patients interact with their general practitioner (GP). While e-consultations can improve patient access to GP care, concerns about increased workload for GPs are raised.
Objective: This study aimed to address three research questions: (1) For what purpose and with what expectations do patients initiate e-consultations? (2) If e-consultations had not been available, what alternative actions would the patient have taken? and (3) How are the alternative actions associated with patient and e-consultation characteristics?
Methods: A cross-sectional study was conducted through a web-based survey on Helsenorge.
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