title: Quality in Australian after-hours doctor home visits: exploring the clinical, professional and security supports available to involved practitioners.
abstract: OBJECTIVE
  The after-hours house call (AHHC) services in Australia has gained huge popularity in recent years, but it is not clear how well supported the involved doctors feel regarding the clinical, professional and security aspects of their work. It is important that this knowledge gap is filled given that appropriate support helps engender quality in health service delivery.
  
  
  METHODS
  This is a questionnaire-based electronic survey involving a sample frame of all 300 doctors participating in AHHC through the National Home Doctor Service. National Home Doctor Service is Australia's largest AHHC service provider.
  
  
  RESULTS
  A total of 168 valid responses (56.0%) were received. Overall, the mean support levels were mild to moderate, ranging from 2.4 to 2.8 out of 4.0 for all three parameters. Specifically, 65.3% of the respondents felt well-supported on clinical issues, 64.7% on professional issues and 43.2% on security issues. Australian-trained doctors were less likely to feel well supported on all aspects [Clinical: odds ratio (OR) 0.38, confidence interval (CI) 0.16 to 0.90; Professional: OR 0.30, CI 0.13 to 0.72; and Security: OR 0.22; CI 0.09 to 0.53] compared with overseas-trained ones. Unsurprisingly, doctors who adopted protective measures felt significantly better supported regarding security (OR 2.75; CI 1.31 to 5.78).
  
  
  CONCLUSIONS
  There is room for improvement regarding support on AHHC in Australia, and concerned Surgeries should ensure that where available these supports are appropriately utilized.
authors.affiliation: Senior Lecturer, Griffith University School of Medicine, Griffith Health Centre, Gold Coast, Queenland, Australia.
authors.forename: Chris Onyebuchi
authors.identifier: http://orcid.org/0000-0002-9194-1740
authors.initials: CO
authors.lastname: Ifediora
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data*; D001315:Australia; D020000:Decision Support Systems, Clinical; D005260:Female; D006297:Health Services Accessibility; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D012449:Safety
keywords: after-hours; clinical; family doctors; general practice; professional; security; support