title: Patients evaluate accessibility and nurse telephone consultations in out-of-hours GP care: determinants of a negative evaluation.
abstract: OBJECTIVE
  The shift towards large-scale organization of out-of-hours primary healthcare in different western countries has created an important role for the nurse telephone consultation. We explored the association between negative patient evaluation of nurse telephone consultations and characteristics of patients and GP cooperatives.
  
  
  METHODS
  A cross-sectional study using postal patient questionnaires sent to patients receiving a nurse telephone consultation from one of 26 GP cooperatives in the Netherlands.
  
  
  RESULTS
  The total response was 49.3% (2583/5239). Negative evaluations were most frequently encountered for the general information received on the GP cooperative (35%). When patients expected a centre consultation or home visit, but only received a nurse telephone consultation, they were more negative about the accessibility (OR 1.7, CI 1.4-2.1) and nurse telephone consultation (OR 4.2, CI 3.2-5.6). In the presence of a special supervising telephone doctor at the cooperative's call centre, nurse telephone consultation was evaluated significantly less negative (OR 0.4, CI 0.2-0.8).
  
  
  CONCLUSIONS
  Expectation of care mode was most strongly associated with a negative evaluation of nurse telephone consultation. The presence of a supervising telephone doctor may lead to a better evaluation of nurse telephone consultations.
  
  
  CONCLUSIONS
  More attention should be paid to the provision of patient information on the GP cooperative and discrepancies between the care expected and the care offered.
authors.affiliation: Centre for Quality-of-Care Research (WOK), Radboud University, Nijmegen Medical Centre, WOK 117, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. p.giesen@voha.umcn.nl
authors.forename: Paul
authors.initials: P
authors.lastname: Giesen
authors.forename: Eric
authors.initials: E
authors.lastname: Moll van Charante
authors.forename: Henk
authors.initials: H
authors.lastname: Mokkink
authors.forename: Patrick
authors.initials: P
authors.lastname: Bindels
authors.forename: Wil
authors.initials: W
authors.lastname: van den Bosch
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
mesh_terms: D039602:After-Hours Care / Q000592:standards*; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D032022:Delegation, Professional; D005194:Family Practice / Q000592:standards; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006302:Health Services Research; D015277:Hotlines / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015403:Nursing Evaluation Research; D009740:Nursing Staff / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards; D012017:Referral and Consultation / Q000592:standards; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration; D014218:Triage / Q000592:standards