Out-of-hours primary care. Implications of organisation on costs

<p>Abstract</p> <p>Background</p> <p>To perform out-of-hours primary care, Dutch general practitioners (GPs) have organised themselves in large-scale GP cooperatives. Roughly, two models of out-of-hours care can be distinguished; GP cooperatives working separate from th...

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Main Authors: Wesseling Geertjan, Voss Gemma BWE, Ament Andre JHA, van Uden Caro JT, Winkens Ron AG, van Schayck Onno CP, Crebolder Harry FJM
Format: Article
Language:English
Published: BMC 2006-05-01
Series:BMC Family Practice
Online Access:http://www.biomedcentral.com/1471-2296/7/29
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spelling doaj-d664bd33b26e49dead64ed4602cb72bc2020-11-25T01:38:37ZengBMCBMC Family Practice1471-22962006-05-01712910.1186/1471-2296-7-29Out-of-hours primary care. Implications of organisation on costsWesseling GeertjanVoss Gemma BWEAment Andre JHAvan Uden Caro JTWinkens Ron AGvan Schayck Onno CPCrebolder Harry FJM<p>Abstract</p> <p>Background</p> <p>To perform out-of-hours primary care, Dutch general practitioners (GPs) have organised themselves in large-scale GP cooperatives. Roughly, two models of out-of-hours care can be distinguished; GP cooperatives working separate from the hospital emergency department (ED) and GP cooperatives integrated with the hospital ED. Research has shown differences in care utilisation between these two models; a significant shift in the integrated model from utilisation of ED care to primary care. These differences may have implications on costs, however, until now this has not been investigated. This study was performed to provide insight in costs of these two different models of out-of-hours care.</p> <p>Methods</p> <p>Annual reports of two GP cooperatives (one separate from and one integrated with a hospital emergency department) in 2003 were analysed on costs and use of out-of-hours care. Costs were calculated per capita. Comparisons were made between the two cooperatives. In addition, a comparison was made between the costs of the hospital ED of the integrated model before and after the set up of the GP cooperative were analysed.</p> <p>Results</p> <p>Costs per capita of the GP cooperative in the integrated model were slightly higher than in the separate model (ε 11.47 and ε 10.54 respectively). Differences were mainly caused by personnel and other costs, including transportation, interest, cleaning, computers and overhead. Despite a significant reduction in patients utilising ED care as a result of the introduction of the GP cooperative integrated within the ED, the costs of the ED remained the same.</p> <p>Conclusion</p> <p>The study results show that the costs of primary care appear to be more dependent on the size of the population the cooperative covers than on the way the GP cooperative is organised, i.e. separated versus integrated. In addition, despite the substantial reduction of patients, locating the GP cooperative at the same site as the ED was found to have little effect on costs of the ED. Sharing more facilities and personnel between the ED and the GP cooperative may improve cost-efficiency.</p> http://www.biomedcentral.com/1471-2296/7/29
collection DOAJ
language English
format Article
sources DOAJ
author Wesseling Geertjan
Voss Gemma BWE
Ament Andre JHA
van Uden Caro JT
Winkens Ron AG
van Schayck Onno CP
Crebolder Harry FJM
spellingShingle Wesseling Geertjan
Voss Gemma BWE
Ament Andre JHA
van Uden Caro JT
Winkens Ron AG
van Schayck Onno CP
Crebolder Harry FJM
Out-of-hours primary care. Implications of organisation on costs
BMC Family Practice
author_facet Wesseling Geertjan
Voss Gemma BWE
Ament Andre JHA
van Uden Caro JT
Winkens Ron AG
van Schayck Onno CP
Crebolder Harry FJM
author_sort Wesseling Geertjan
title Out-of-hours primary care. Implications of organisation on costs
title_short Out-of-hours primary care. Implications of organisation on costs
title_full Out-of-hours primary care. Implications of organisation on costs
title_fullStr Out-of-hours primary care. Implications of organisation on costs
title_full_unstemmed Out-of-hours primary care. Implications of organisation on costs
title_sort out-of-hours primary care. implications of organisation on costs
publisher BMC
series BMC Family Practice
issn 1471-2296
publishDate 2006-05-01
description <p>Abstract</p> <p>Background</p> <p>To perform out-of-hours primary care, Dutch general practitioners (GPs) have organised themselves in large-scale GP cooperatives. Roughly, two models of out-of-hours care can be distinguished; GP cooperatives working separate from the hospital emergency department (ED) and GP cooperatives integrated with the hospital ED. Research has shown differences in care utilisation between these two models; a significant shift in the integrated model from utilisation of ED care to primary care. These differences may have implications on costs, however, until now this has not been investigated. This study was performed to provide insight in costs of these two different models of out-of-hours care.</p> <p>Methods</p> <p>Annual reports of two GP cooperatives (one separate from and one integrated with a hospital emergency department) in 2003 were analysed on costs and use of out-of-hours care. Costs were calculated per capita. Comparisons were made between the two cooperatives. In addition, a comparison was made between the costs of the hospital ED of the integrated model before and after the set up of the GP cooperative were analysed.</p> <p>Results</p> <p>Costs per capita of the GP cooperative in the integrated model were slightly higher than in the separate model (ε 11.47 and ε 10.54 respectively). Differences were mainly caused by personnel and other costs, including transportation, interest, cleaning, computers and overhead. Despite a significant reduction in patients utilising ED care as a result of the introduction of the GP cooperative integrated within the ED, the costs of the ED remained the same.</p> <p>Conclusion</p> <p>The study results show that the costs of primary care appear to be more dependent on the size of the population the cooperative covers than on the way the GP cooperative is organised, i.e. separated versus integrated. In addition, despite the substantial reduction of patients, locating the GP cooperative at the same site as the ED was found to have little effect on costs of the ED. Sharing more facilities and personnel between the ED and the GP cooperative may improve cost-efficiency.</p>
url http://www.biomedcentral.com/1471-2296/7/29
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