title: Follow-up after telephone consultations at out-of-hours primary care.
abstract: BACKGROUND
  After a contact with a primary care physician (PCP) cooperative for out-of-hours care, many patients have subsequent contact with health care. Little is known about the factors associated with these follow-up contacts. The objective of this study was to examine whether patient experiences with nurse telephone consultations and the cooperative's organizational characteristics were associated with the probability of follow-up contact.
  
  
  METHODS
  We conducted a cross-sectional study of patients attending 16 Dutch PCP cooperatives (2009 to 2011) using a validated questionnaire to measure patient experiences with nurse telephone consultations and patient-reported follow-up. Participating cooperatives provided information on 12 organizational characteristics. Multilevel regression modeling was used to identify associations.
  
  
  RESULTS
  A total of 7039 patients returned a questionnaire (50.4%), of which 5678 were complete. About half of patients reported a follow-up contact (47%). Regression analyses showed increasing probability of follow-up contact in patients with higher age (≥65 years; odds ratio [OR], 2.39), patients receiving a home visit (OR, 1.32), and cooperatives with a higher percentage of telephone consultations (OR, 1.02) and a decreased probability among patients with more positive experiences with a nurse via telephone contact (OR, 0.68).
  
  
  CONCLUSIONS
  Although follow-up contacts can be medically required, a substantial number of contacts seem to be not required and thus are potentially avoidable (eg, by changes in work routine and communication).
authors.affiliation: the Radboud University Nijmegen Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands. L.Huibers@iq.umcn.nl
authors.forename: Linda
authors.initials: L
authors.lastname: Huibers
authors.forename: Jan
authors.initials: J
authors.lastname: Koetsenruijter
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
authors.forename: Paul
authors.initials: P
authors.lastname: Giesen
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
mesh_terms: D000293:Adolescent; D000328:Adult; D039602:After-Hours Care; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D005260:Female; D015277:Hotlines; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D017060:Patient Satisfaction; D011320:Primary Health Care; D055817:Telenursing; D014218:Triage
keywords: Out-of-Hours Medical Care; Patient Satisfaction; Primary Health Care; Telemedicine; Triage; Utilization