title: [Contacts outside of office hours: complaints presented to the general practitioner and to the emergency department].
abstract: 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.
  
  
  METHODS
  Descriptive.
  
  
  METHODS
  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.
authors.affiliation: Divisie Public Health, afd. Huisartsgeneeskunde, Academisch Medisch Centrum/Universiteit van Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam.
authors.forename: C J
authors.initials: CJ
authors.lastname: Ijzermans
authors.forename: S
authors.initials: S
authors.lastname: Mentink
authors.forename: L M M
authors.initials: LM
authors.lastname: Klaphake
authors.forename: J J M
authors.initials: JJ
authors.lastname: van Grieken
authors.forename: P J E
authors.initials: PJ
authors.lastname: Bindels
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data*; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010821:Physicians, Family; D011320:Primary Health Care; D012017:Referral and Consultation