title: General practitioners' perceptions of the appropriateness and inappropriateness of out-of-hours calls.
abstract: BACKGROUND
  The number of out-of-hours calls to general practitioners (GPs) has increased steadily during the past 20 years. The proportion of inappropriate calls are reportedly increasing but we know very little about how GPs judge a call to be appropriate or inappropriate.
  
  
  OBJECTIVE
  To determine the factors that influence GPs' perceptions of the appropriateness or inappropriateness of out-of-hours calls.
  
  
  METHODS
  Postal questionnaire survey.
  
  
  METHODS
  GP members of the Wessex Primary Care Research Network (WReN) and the Northern Primary Care Research Network (NoReN).
  
  
  METHODS
  General Practitioners were asked to write down what they meant by an 'appropriate' and 'inappropriate' out-of-hours call. The free text was subjected to content analysis.
  
  
  RESULTS
  Detailed responses were received from 146 (73%) GPs. General practitioners appear to have a well developed classification of the appropriateness of out-of-hours calls. Factors that make calls appropriate include not only the nature of patients' symptoms and illness but also non-medical factors such as patients' compliance and politeness.
  
  
  CONCLUSIONS
  The inclusion by GPs of non-medical factors in their conceptualisation of the appropriateness of out-of-hours calls may contribute to patients' confusion about what is and is not appropriate and also to the apparent failure of patient education initiatives designed to decrease inappropriate demand.
authors.affiliation: Health Care Research Unit, University of Southampton.
authors.forename: H
authors.initials: H
authors.lastname: Smith
authors.forename: V
authors.initials: V
authors.lastname: Lattimer
authors.forename: S
authors.initials: S
authors.lastname: George
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004739:England; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009551:Night Care / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000523:psychology*