title: After-hours primary care for people with intellectual disabilities in The Netherlands-Current arrangements and challenges.
abstract: BACKGROUND
  Little is known about the organisation of after-hours primary care for people with intellectual disabilities (ID), and mainstream care is not self-evidently accessible or fit for this group. A first step towards improvement is a greater understanding of current after-hours primary ID care.
  
  
  OBJECTIVE
  This study explores the organisation of and experiences with after-hours primary care provided for people with ID in The Netherlands.
  
  
  METHODS
  A telephone survey amongst 68 care provider services including questions on organisational characteristics, problem areas, facilitators, and inhibitors.
  
  
  RESULTS
  A multitude of different after-hours primary care arrangements were found. Primary care physicians (PCPs) were involved in almost all care provider services, often in alliance with PCP cooperatives. Specialised ID physicians had differing roles as gatekeeper, primary caregiver, or consultant. Most problems during the after-hours arose regarding daily care professionals' competences. Facilitators and inhibitors of after-hours primary care were themed around complexity of, and need for, specialised care, multidisciplinary team of professionals, communication and information, and prerequisites at organisational level.
  
  
  CONCLUSIONS
  Evidence on specific after-hours health needs of people with ID is needed to strengthen collaboration between specialist ID care services and mainstream healthcare services to adequately provide care.
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Marloes.Heutmekers@radboudumc.nl.
authors.forename: Marloes
authors.initials: M
authors.lastname: Heutmekers
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Jenneken.Naaldenberg@radboudumc.nl.
authors.forename: Jenneken
authors.initials: J
authors.lastname: Naaldenberg
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Tessa.Frankena@radboudumc.nl.
authors.forename: Tessa K
authors.initials: TK
authors.lastname: Frankena
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department IQ healthcare, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Marleen.Smits@radboudumc.nl.
authors.forename: Marleen
authors.initials: M
authors.lastname: Smits
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Geraline.Leusink@radboudumc.nl.
authors.forename: Geraline L
authors.initials: GL
authors.lastname: Leusink
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Pim.Assendelft@radboudumc.nl.
authors.forename: Willem J J
authors.initials: WJJ
authors.lastname: Assendelft
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Henny.Lantman@radboudumc.nl.
authors.forename: Henny M J
authors.initials: HMJ
authors.lastname: van Schrojenstein Lantman-de Valk
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration* / Q000592:standards; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000592:standards*; D002983:Clinical Competence; D066275:Health Information Exchange; D006801:Humans; D008607:Intellectual Disability; D009426:Netherlands; D009726:Nurses; D010820:Physicians; D058007:Physicians, Primary Care / Q000592:standards; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D011795:Surveys and Questionnaires; D014218:Triage; D035862:Vulnerable Populations; D016526:Workload
keywords: After-hours care; Intellectual disability; Primary healthcare