From: Migrants’ motives and expectations for contacting out-of-hours primary care: a survey study
Theme | Feature |
---|---|
General | Out-of-hours primary care has been provided by large-scale general practitioner (GP) cooperatives since the year 2000 |
Every GP has to do a minimum number of shifts at the GP cooperative to maintain his/her registration as a GP. | |
Participation of 50–250 GPs per cooperative with a mean of 4 h on call per week with a compensation of about €65/h | |
About 120 GP cooperatives in the Netherlands | |
Population of 100,000 to 500,000 patients with an average care consumption of 250 contacts/1000 inhabitants per year | |
Out-of-hours defined as daily from 5 p.m. to 8 a.m., all public holidays and the entire weekend | |
Per shift GPs have different roles: supervising telephone triage, doing centre consultations or home visits | |
The triage is supervised by telephone consultation doctors who can be consulted in case of doubt, while also checking and authorising all calls | |
Location | GP cooperative usually situated in or near a hospital |
Distance of patients to GP cooperative is 30 km at most | |
Accessibility | Access via a single regional telephone number, meaning the first contact is mostly with a triage nurse (only 5–10% walk in without a call in advance) |
Telephone triage by nurses supervised by GPs: contacts are divided into telephone advice (38%), centre consult (52%), or GP home visit (9%) | |
Facilities | Home visits are supported by trained drivers in identifiable fully equipped GP cars (e.g. oxygen, intra venous drip equipment, automated external defibrillator, medication for acute treatment) |
Information and communication technology (ICT) support including electronic patient files, online connection to the GP’s car, and sometimes connection with the electronic medical record in the GP’s daily practice | |
Charging system | Healthcare is largely covered by health insurance |
All residents over 18 years pay a monthly premium to their health insurance provider. There is no premium for children | |
Employers pay a part of their employee’s income to the tax administration for healthcare costs | |
Patients do not have to pay an additional amount for GP care, both during and outside office hours | |
Residents over 18 years must an annual deductible (385 euro in 2016) in case of use of healthcare (including emergency departments). This deductible is neither applicable to GP care, nor to children |