scholarly journals From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service: Simulated Effects on Costs

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Grete Moth ◽  
Linda Huibers ◽  
Peter Vedsted
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Care Service ◽  
Primary Care Service ◽  
Nurse Training ◽  
Out Of Hours ◽  
Face To Face ◽  
Administrative Costs ◽  
The Cost ◽  
Nurse Triage

Introduction. General practitioners (GP) answer calls to the Danish out-of-hours primary care service (OOH) in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We applied experiences from The Netherlands on nurse performance in the OOH triage concerning the number of calls per hour. Using the 2011 number of calls in one region, we examined three hypothetical scenarios with nurse triage and calculated the differences in fee costs. Results. A new organisation with 97 employed nurses would be needed. Fewer telephone consultations may result in an increase of face-to-face contacts, resulting in an increase of 23.6% in costs fees. Under optimal circumstances (e.g., a lower demand for OOH services, a high telephone termination rate, and unchanged GP fees) the costs could be reduced by 26.2% though excluding administrative costs of a new organisation. Conclusion. Substituting GPs with nurses in OOH primary care may increase the cost in fees compared to a model with only GPs. Further research is needed involving more influencing factors, such as costs due to nurse training and running the organisation.

Role of out of hours primary care service in limiting inappropriate access to emergency department

2017 ◽  
Vol 13 (4) ◽  
pp. 549-555 ◽  
Author(s):  
Andrea Posocco ◽  
Maria Paola Scapinello ◽  
Irene De Ronch ◽  
Francesco Castrogiovanni ◽  
Gianluca Lollo ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Care Service ◽  
Primary Care Service ◽  
Out Of Hours

scholarly journals Daytime use of general practice and use of the Out-of-Hours Primary Care Service for patients with chronic disease: a cohort study

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Lone Flarup ◽  
Grete Moth ◽  
Morten Bondo Christensen ◽  
Mogens Vestergaard ◽  
Frede Olesen ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cohort Study ◽  
Chronic Disease ◽  
Care Service ◽  
Primary Care Service ◽  
Out Of Hours

scholarly journals Paediatric contacts with the UK out-of-hours primary care service and contact outcomes: a regional service evaluation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
George Edwards ◽  
Rachel Brettell ◽  
Chris Bird ◽  
Helen Hunt ◽  
Dan Lasserson ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Service ◽  
Service Evaluation ◽  
Primary Care Service ◽  
Out Of Hours ◽  
Regional Service ◽  
The Uk

scholarly journals Course of Uncomplicated Acute Gastroenteritis in Children Presenting to Out-of-hours Primary Care

2021 ◽  
Author(s):  
Anouk AH Weghorst ◽  
Irma J Bonvanie ◽  
Gea A Holtman ◽  
Michiel R de Boer ◽  
Marjolein Y Berger
Keyword(s):  
Primary Care ◽  
Acute Gastroenteritis ◽  
Care Service ◽  
Primary Care Service ◽  
Symptom Duration ◽  
Out Of Hours ◽  
Typical Symptom ◽  
Follow Up Study ◽  
Increased Risk

Abstract Background: The aim of this article is to describe the courses of vomiting, diarrhea, fever, and clinical deterioration, in children with uncomplicated gastroenteritis at presentation. This study was performed as a 7-day prospective follow-up study in an out-of-hours primary care service. The course of vomiting, diarrhea, and fever was analyzed by generalized linear mixed modeling. Because young children (≤12 months) and children with severe vomiting are at increased risk of dehydration, the potentially more complicated courses of these groups are described separately. The day(s) most frequently associated with deterioration and the symptoms present in children who deteriorated during follow-up were also described.Results: In total, 359 children presented with uncomplicated acute gastroenteritis to the out-of-hours primary care service. Of these, 31 (8.6%) developed a complicated illness and needed referral or hospitalization. All symptoms decreased within 5 days in most children (>90%). Vomiting and fever decreased rapidly, but diarrhea decreased at a somewhat slower pace, especially among children aged 6–12 months. Children who deteriorated during follow-up had a higher frequency of vomiting at presentation and higher frequencies of vomiting and fever during follow-up.Conclusions: The frequency of vomiting, not its duration, appears to be the more important predictor of deterioration. When advising parents, it is important to explain the typical symptom duration and to focus on alarm symptoms. Clinicians should be vigilant for children with higher vomiting frequencies at presentation and during follow-up because these children are more likely to deteriorate.

Marginal assessment of the cost and benefits of aphasia treatment: Evidence from community-based telerehabilitation treatment for aphasia

2021 ◽  
pp. 1357633X2098277
Author(s):  
Molly Jacobs ◽  
Patrick M Briley ◽  
Heather Harris Wright ◽  
Charles Ellis
Keyword(s):  
Cost Effectiveness ◽  
Economies Of Scale ◽  
Reference Group ◽  
Unit Cost ◽  
Community Based ◽  
Face To Face ◽  
Conduction Aphasia ◽  
Aphasia Treatment ◽  
The Cost ◽  
The Relationship

Introduction Few studies have reported information related to the cost-effectiveness of traditional face-to-face treatments for aphasia. The emergence and demand for telepractice approaches to aphasia treatment has resulted in an urgent need to understand the costs and cost-benefits of this approach. Methods Eighteen stroke survivors with aphasia completed community-based aphasia telerehabilitation treatment, utilizing the Language-Oriented Treatment (LOT) delivered via Webex videoconferencing program. Marginal benefits to treatment were calculated as the change in Western Aphasia Battery-Revised (WAB-R) score pre- and post-treatment and marginal cost of treatment was calculated as the relationship between change in WAB-R aphasia quotient (AQ) and the average cost per treatment. Controlling for demographic variables, Bayesian estimation evaluated the primary contributors to WAB-R change and assessed cost-effectiveness of treatment by aphasia type. Results Thirteen out of 18 participants experienced significant improvement in WAB-R AQ following telerehabilitation delivered therapy. Compared to anomic aphasia (reference group), those with conduction aphasia had relatively similar levels of improvement whereas those with Broca’s aphasia had smaller improvement. Those with global aphasia had the largest improvement. Each one-point of improvement cost between US$89 and US$864 for those who improved (mean = US$200) depending on aphasia type/severity. Discussion Individuals with severe aphasia may have the greatest gains per unit cost from treatment. Both improvement magnitude and the cost per unit of improvement were driven by aphasia type, severity and race. Economies of scale to aphasia treatment–cost may be minimized by treating a variety of types of aphasia at various levels of severity.

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