Veranderingen in patiëntencontacten na centralisatie van huisartsenzorg op een spoedeisendehulpafdeling

Objective: Evaluation of changes in the numbers and characteristics of patients after centralisation of GPs' out-of-hours care integrated with the Accident and Emergency department (A&E). Method: In the period from 1 to 14 November 1999 and the same period in 2000, all patients attending the A&E and the Emergency Coronary Care department of the Academic Hospital in Maastricht, transported by the ambulance service of Maastricht and cared for by the centralised GPs' out-of-hours care service were recorded. Results: A decrease of 25% in the number of patients attending the A&E occurred after the centralised GPs' out-of-hours care was integrated with the A&E. This was mainly due to a decrease in self-referrals. Treatment characteristics varied depending on the source of the referral to the A&E. Fewer patients than expected contacted the centralised GPs' out-of-hours care. A shift in the nature of contact was observed: a considerable decrease in telephone calls and house calls and an increase in the number of consultations. Conclusion: Integration of centralised GPs' out-of-hours care with the A&E decreased the number of patients attending the A&E by 25%. General practitioners provide better selection than self-referred patients. Out of hours, inappropriate attenders at the A&E are filtered out by the GPs.