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. 2017 Dec 28;18(1):112.
doi: 10.1186/s12875-017-0702-5.

Preschool children in out-of-hours primary care - a questionnaire-based cross-sectional study of factors related to the medical relevance of health problems

Grete Moth  1   2 , Linda Huibers  3   4 , Astrid Ovesen  3   4 , Morten Bondo Christensen  3   4 , Peter Vedsted  3   4
Affiliations

Preschool children in out-of-hours primary care - a questionnaire-based cross-sectional study of factors related to the medical relevance of health problems

Grete Moth et al. BMC Fam Pract. .

Abstract

Background: Out-of-hours primary care (OOH-PC) is intended to provide medical care services for health problems that cannot wait until normal office hours. Children under five years of age represent about 19% of all OOH-PC contacts in Denmark, and the frequency of calls assessed as severe by health professionals is markedly lower for children than for other age groups. Several studies have questioned the appropriateness of the parents' use of OOH-PC. We aimed to identify factors associated with calls from parents of pre-school children concerning perceived non-severe health problems that were ranked by the triaging GPs as more appropriate for GP office hours (defined as 'medically irrelevant').

Methods: We used data from a cross-sectional study performed in the Central Denmark Region for a 1-year period during 2010-2011. GPs in the OOH-PC assessed random contacts, and a questionnaire was subsequently sent to registered patients. Associations between different factors and the medical irrelevance of contacts were estimated with a generalised linear model to calculate the prevalence ratio (PR).

Results: Among all included 522 telephone consultations and 1226 face-to-face consultations, we identified 71 (13.6%) telephone consultations and 95 (7.8%) face-to-face consultations that were both assessed as non-severe by the parents and more appropriate for GP office hours by the GPs. For telephone consultations, contacts at other times than 4-8 pm on weekdays were statistically significantly associated with medical irrelevance. Additionally, symptoms of longer duration than 24 h were statistically significantly associated medical irrelevance.

Conclusions: A large part of the calls to the Danish OOH-PC concern children. The results indicate that some of these calls are made for other than strictly medical reasons. To achieve more effective use of available resources, it might seem relevant to aim at directing more contacts directly to daytime care. However, future studies to enhance our knowledge on parents' motivation and behaviour would be recommendable.

Keywords: Appropriateness; Denmark; General practice; Out-of-hours; Reason for encounter; Severity.

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Conflict of interest statement

Ethics approval and consent to participate

The project was approved by the Danish Data Protection Agency (R. no. 2009–41-4069) and by the Danish Health and Medicines Authority (R. no. 7–604–04-2/122/EHE). According to Danish law, approval from the health research ethics committee system was not needed (http://www.nvk.dk/). A specific written consent was not obtained, as the participants, GPs and patients, were informed that accepting to fill out and return questionnaires meant giving consent. The participating GPs received a fee that was dependent on the number of registered contacts.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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