Retrospective analysis of a suburban out-of-hours clinic in Belgium.

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2014-10-01 Epub Date: 2014-07-24 DOI:10.1179/2295333714Y.0000000052
J L Belche, M A Berrewaerts, P Burette, A L Lenoir, C Duchesnes, D Giet
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引用次数: 5

Abstract

Introduction: In many countries, out-of-hours medical care is under scrutiny. The aim of this article is to study the activities recorded by the first out-of-hours clinic that has been opened, as a pilot study, in two Walloon communes.

Material and method: A retrospective analysis of anonymized data was conducted for 2009. Coding of diagnoses was conducted using the International Classification of Primary Care (ICPC-2).

Results: A total of 3949 contacts were recorded in 2009 with the out-of-hours clinic, 3294 related to inhabitants of the two communes covered, which was equivalent to 13% of the total population in question. Compared to 7·2% of contacts between midnight and 8 a.m., 82·9% of contacts took place between 8 a.m. and 9 p.m., and 91·6% of contacts were handled locally, with only 8·4% resulting in hospitalization. In addition, 52% of contacts were with patients aged between 25 and 65; 29·9% of contacts were with paediatric patients (<15 years). Patients over the age of 65 made up 18% of contacts. The most common pathologies were respiratory (R). Analysis of flu diagnoses identified two epidemic peaks.

Discussion: The suburban out-of-hours clinic studied fulfilled an important role in managing the demand for health care. The large majority of health problems were resolved locally, and the inhabitants did not need to go to hospital. Appointments between midnight and 8 a.m. were in the minority, which points towards adjusting the organization of the out-of-hours service during the night. The geriatric population is not highly over-represented contrary to what might be expected considering its largest number of pathologies. The on-call doctor's skills profile should take account of the populations and morbidities encountered. Out-of-hours clinics could possibly play a sentinel role in terms of flu epidemics.

Conclusion: This study describes a pilot suburban out-of-hours clinic which met three of recommendations set by the KCE in its report on out-of-hours care in general medicine: the organization of an out-of-hours clinic with logistical support, the use of a single telephone number and merging out-of-hours areas. While debate exists on the management of out-of-hours care, this study provides evidence on the role of the physician during these hours.

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比利时郊区一家非工作时间诊所的回顾性分析。
导言:在许多国家,非工作时间的医疗服务受到严格审查。本文的目的是研究作为试点研究在两个瓦隆公社开设的第一家非工作时间诊所所记录的活动。材料与方法:对2009年匿名数据进行回顾性分析。使用国际初级保健分类(ICPC-2)对诊断进行编码。结果:2009年与非工作时间诊所共记录了3949次接触,其中3294次与两个社区的居民有关,相当于所述总人口的13%。与午夜至上午8点之间的7.2%的接触相比,82.9%的接触发生在上午8点至晚上9点之间,91.6%的接触是在当地处理的,只有8.4%的接触导致住院。此外,52%的接触者是年龄在25至65岁之间的患者;29.9%的接触者是儿科患者(讨论:所研究的郊区非工作时间诊所在管理卫生保健需求方面发挥了重要作用。绝大多数健康问题在当地得到解决,居民不需要去医院。在午夜至上午8点之间的预约占少数,这表明需要调整夜间非工作时间服务的安排。考虑到其最大的病理数量,老年人口并没有高度过度代表。应召医生的技能概况应考虑到所遇到的人群和发病率。非工作时间的诊所可能在流感流行方面发挥哨兵作用。结论:本研究描述了一个郊区非工作时间诊所的试点,该诊所满足了KCE在其关于全科医学非工作时间护理的报告中提出的三项建议:组织一个具有后勤支持的非工作时间诊所,使用单一电话号码和合并非工作时间区域。尽管关于非工作时间护理的管理存在争议,但本研究为医生在非工作时间的作用提供了证据。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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