Out-of-hours primary care: a population-based study of the diagnostic scope of telephone contacts

Fam Pract. 2016 Oct;33(5):504-9. doi: 10.1093/fampra/cmw048. Epub 2016 Jun 21.


Background: GPs answer all patient calls to the out-of-hours primary care (OOH-PC) services in Denmark. Knowledge is scarce on how the triage-GPs act on the specific reasons for encounter (RFE).

Objective: This study aims to describe the RFEs, the applied diagnoses and the severity of health problems presented in calls to the OOH-PC.

Methods: This was a 1-year cross-sectional study based on IT-integrated pop-up questionnaires addressing patients' health problems. We included only telephone contacts that were categorized according to their triage outcome as telephone consultations, direct admissions to hospital or referrals for face-to-face contact. The GP-assessed severity was calculated for age groups and types of outcome. We identified the 20 most frequent primary RFEs and diagnoses for each type of contact termination.

Results: We included 7810 telephone calls. Calls considered non-severe made up two-thirds of the calls terminated as telephone consultations, whereas calls considered potentially severe made up the main part of referrals (52.3%). Overall, the 20 most frequent RFEs accounted for 45.2% of all RFEs, fever being the most frequent (10.0%). Some RFEs were terminated mostly as telephone consultations [e.g. insect bite/sting (75.9%)], whereas others were most often referred for a face-to-face contact [i.e. dyspnoea (79.1%)] or directly to hospital [i.e. chest pain (29.4%)].

Conclusion: The distribution of the RFEs on triage outcomes, dominated by more severe diagnoses in referrals indicates a suitable referral level. However, future research on factors related to the demanding task of telephone triage is highly relevant for postdoctoral training of GPs.

Keywords: After hours; Denmark; diagnosis; primary health care; reason for encounter; severity; triage..

MeSH terms

  • Adolescent
  • Adult
  • After-Hours Care / statistics & numerical data*
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Denmark
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Primary Health Care / methods*
  • Referral and Consultation / statistics & numerical data*
  • Surveys and Questionnaires
  • Telephone / statistics & numerical data*
  • Triage*
  • Young Adult