title: Reducing the use of out-of-hours primary care services: A survey among Dutch general practitioners.
abstract: BACKGROUND
  Out-of-hours primary care services have a high general practitioner (GP) workload with increasing costs, while half of all contacts are non-urgent.
  
  
  OBJECTIVE
  To identify views of GPs to influence the use of the out-of-hours GP cooperatives.
  
  
  METHODS
  Cross-sectional survey study among a random sample of 800 GPs in the Netherlands.
  
  
  RESULTS
  Of the 428 respondents (53.5% response rate), 86.5% confirmed an increase in their workload and 91.8% felt that the number of patient contacts could be reduced. A total of 75.4% GP respondents reported that the 24-h service society was a 'very important' reason why patients with non-urgent problems attended the GP cooperative; the equivalent for worry or anxiety was 65.8%, and for easy accessibility, 60.1%. Many GPs (83.9%) believed that the way telephone triage is currently performed contributes to the high use of GP cooperatives. Measures that GPs believed were both desirable and effective in reducing the use of GP cooperatives included co-payment for patients, stricter triage, and a larger role for the telephone consultation doctor. GPs considered patient education, improved telephone accessibility of daytime general practices, more possibilities for same-day appointments, as well as feedback concerning the use of GP cooperatives to practices and triage nurses also desirable, but less effective.
  
  
  CONCLUSIONS
  This study provides several clues for influencing the use of GP cooperatives. Further research is needed to examine the impact and safety of these strategies. [Box: see text].
authors.affiliation: a Radboud University Medical Center, Radboud Institute for Health Sciences , IQ Healthcare , Nijmegen , The Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Keizer
authors.affiliation: a Radboud University Medical Center, Radboud Institute for Health Sciences , IQ Healthcare , Nijmegen , The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: Maassen
authors.affiliation: a Radboud University Medical Center, Radboud Institute for Health Sciences , IQ Healthcare , Nijmegen , The Netherlands.
authors.forename: Marleen
authors.initials: M
authors.lastname: Smits
authors.affiliation: a Radboud University Medical Center, Radboud Institute for Health Sciences , IQ Healthcare , Nijmegen , The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.affiliation: a Radboud University Medical Center, Radboud Institute for Health Sciences , IQ Healthcare , Nijmegen , The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Giesen
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice / Q000458:organization & administration*; D058005:General Practitioners / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011320:Primary Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D016526:Workload
keywords: After-hours care; co-payment; health services accessibility; non-urgent; primary healthcare