General practice cooperatives: long waiting times for home visits due to long distances?

BMC Health Serv Res. 2007 Feb 12:7:19. doi: 10.1186/1472-6963-7-19.

Abstract

Background: The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times.

Methods: Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases.

Results: The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minutes decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km).

Discussion and conclusion: Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance.

MeSH terms

  • After-Hours Care / organization & administration*
  • After-Hours Care / statistics & numerical data
  • Community Networks / organization & administration*
  • Community Networks / statistics & numerical data
  • Cooperative Behavior
  • Cross-Sectional Studies
  • Emergencies / classification
  • Family Practice / organization & administration*
  • Family Practice / statistics & numerical data
  • Health Care Surveys
  • Health Services Accessibility*
  • House Calls / statistics & numerical data*
  • Humans
  • Logistic Models
  • Netherlands
  • Telephone
  • Time Factors
  • Transportation*
  • Triage
  • Waiting Lists