Out of hours service in Denmark: evaluation five years after reform

Abstract

Objective: Five years after its introduction, to evaluate the 1992 reform in the out of hours service in Denmark.

Design: Comparison of data before and after reform. Data were collected from published reports, Danish national health statistics, and the Danish trade union for general practitioners.

Setting: Denmark.

Main outcome measures: Number of out of hours services; workload of general practitioners; cost of the service; patient satisfaction.

Results: Five years after the reform, the percentage of telephone consultations had almost doubled, to 48%. Consultations in doctors' surgeries were relatively unchanged, but home visits were much reduced, to 18%. The percentage of doctors who worked 5 hours or more out of hours per week dropped from about 70% to about 50%. Overall patient satisfaction in 1995 was high (72%).

Conclusion: The organisation of the out of hours service, with a fully trained general practitioner in a telephone triage function, is working satisfactorily. Many calls that previously would have required home visits are now dealt with by telephone or through consultations. The out of hours workload for general practitioners has decreased considerably.

Figures

Figure 1

Out of hours services in Denmark, 1990-6

Figure 2

Out of hours workload of general practitioners, Denmark, 1987-93