[Contacts outside of office hours: complaints presented to the general practitioner and to the emergency department]

Ned Tijdschr Geneeskd. 2002 Jul 27;146(30):1413-7.
[Article in Dutch]


Objective: To determine the differences between the problems presented out-of-hours to general practitioners (GPs) or to the Accident & Emergency (A&E) department of a hospital, and to assess whether the physicians believed the patient was justified in contacting them.

Design: Descriptive.

Method: All the out-of-hours contacts that 33,000 patients on the lists of 22 general practices had with either a duty GP or the A&E department of a nearby hospital (so-called 'self-referrers') were counted during two 3-month periods. In addition, symptoms were classified in both settings using the International Classification of Primary Care (ICPC).

Results: The ratio for contacts between general practice and A&E was 2:1 in the evening and 3:1 at night. The majority of problems presented to the GP was dealt with by telephone. At the A&E, trauma was seen most commonly, while GPs were contacted for infections and (complications of) chronic diseases. A&E physicians judged one out of five reasons for encounter as 'unjustified', while this ratio was one in seven in the case of GPs.

Conclusions: There was only a partial overlap in the nature of the problems presented to an A&E department and those presented to GPs; instead, the two settings appeared to complement each other. The results were influenced by the fact that the A&E department lacked the possibility of dealing with patients by telephone. Both the A&E department and the GPs were contacted by patients who did not need (acute) medical care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents / statistics & numerical data
  • Adolescent
  • Adult
  • After-Hours Care / statistics & numerical data*
  • Aged
  • Child
  • Child, Preschool
  • Emergencies
  • Emergency Service, Hospital / statistics & numerical data*
  • Family Practice / statistics & numerical data*
  • Female
  • Health Services Needs and Demand
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Physicians, Family
  • Primary Health Care
  • Referral and Consultation