After-Hours Information Given by Telephone by Family Physicians in Ontario

Healthcare policyPublished 17 November 2009Open access

Michelle Howard, Glen E. Randall

DOI10.12927/hcpol.2013.21235

Source URL

Citations10

SJR quartileQ3

SJR score0.51

SNIP0.58

View PDF

TL;DR

Many family physician telephone messages in Ontario suggest emergency services only or do not provide any instructions for after-hours care, and only slightly more than half suggest use of the government-funded THAS.

Abstract

This study describes instructions for after-hours care offered by family physicians' offices when patients telephone the practice. Randomly selected (n=1,680) Ontario family physicians and general practitioners were telephoned after hours from October 2007 to February 2008.Instructions among the 1,102 eligible offices suggested emergency services (58.6%; 646/1,102), the toll-free, nurse-staffed Telephone Health Advisory Service (THAS) with on-call physician back-up (45.0%; 496/1,102), the practice's own after-hours clinic (27.9%; 307/1,102), an on-call physician (8.0%; 88/1,102) or a walk-in clinic (6.9%; 76/1,102). Some messages (13.9%; 153/1,102) provided no instructions. Physicians in a reformed model with obligations to provide some after-hours care were more likely to advise an after-hours clinic (32.0%; 285/891) than other physicians (10.4%; 22/211) (p<0.001).Many family physician telephone messages in Ontario suggest emergency services only or do not provide any instructions. Only slightly more than half suggest use of the government-funded THAS. Patients may be unaware of many after-hours care options.

Keywords

Health ProfessionsEconomics, Econometrics and FinanceBusiness, Management and Accounting

PEDIATRICSAssociation of Lower Continuity of Care With Greater Risk of Emergency Department Use and Hospitalization in Children

415 Citations2001Dimitri Christakis, Loren K. Mell +3 more

Lower continuity of primary care is associated with higher risk of ED utilization and hospitalization and efforts to improve and maintain continuity may be warranted.

Archives of Family MedicineThe Effect of Continuity of Care on Emergency Department Use

353 Citations2000J. M. Gill

It is demonstrated that high provider continuity is associated with lower ED use for the Medicaid population, which suggests that strategies to improve continuity of care may result in lowerED use and possibly reduced health care costs.

The Annals of Family MedicinePatient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

58 Citations2007Michelle Howard, J. Goertzen +3 more

Satisfaction with care received for an urgent health problem from their family physician, at an after-hours clinic in which their physician participated, at a walk-in clinic, at the emergency department, from telephone health advisory services, or from more than 1 of those services is compared.

View PDF

PubMedRe-utilization outcomes and costs of minor acute illness treated at family physician offices, walk-in clinics, and emergency departments.

50 Citations2005M. Karen Campbell, Rachel Wulf Silver +7 more

Both re-utilization rates and costs are higher for those seeking care in EDs for minor acute illness and the initial visit was the largest component of cost in all settings, and this component was consistently higher inEDs.

View PDF

PubMedAfter-hours care in Canada: analysis of the 2001 National Family Physician Workforce Survey.

13 Citations2005Eric Crighton, Risa Bordman +5 more

Knowledge of these factors can be used to inform policy development for after-hours service arrangements, which is particularly relevant today, given provincial governments' interests in exploring alternative payment plans and primary care reform options.

PubMedAfter-hours services in capitation-funded primary care practice: use and satisfaction.

3 Citations2009Ieva Neimanis, Janusz Kaczorowski +1 more

Patients' use of and satisfaction with the nurse-staffed Telephone Health Advisory Service (THAS) and physician after-hours care in a rostered Family Health Organization, as well as physicians' satisfaction with both types of services are examined.

PubMedTypology of after-hours care instructions for patients: telephone survey and multivariate analysis.

1 Citations2007Risa Bordman, Monica Bovett +5 more

Important issues identified included the recommendation to use an emergency department as the sole source of AHC, practices providing no specific AHC instructions to their patients, and physicians' lack of acceptance of Telehealth.