Table 1 Organizational models for out-of-hours care
From: Out-of-hours care in western countries: assessment of different organizational models
Organizational model | Definition | Example |
|---|---|---|
Small family doctor based models (registration at a family doctor practice) | ||
Individual general family practice | The GP takes care of his own patients 24 hours a day, 7 days a week. | Rural areas of Austria |
Rota groups (rota) | GPs who are active in the same region take turns being on duty out-of-hours for the patient population of all (up to 15) members of the rota group | Municipalities in Norway |
Large family doctor based models (independent of registration at a family doctor practice) | ||
GP cooperatives | GPs work in a non-profit organization and take turns being on duty out-of-hours for the patient population of all participating GPs. These are large-scale organizations that are supported by nurses, management, chauffeurs, et cetera. | Mostly used model for out-of-hours primary care in the Netherlands |
Primary care centers (PCC) | Centers, which patients can visit without an appointment for minor injuries or illnesses. Such centers operate under supervision of a general practitioner or family physician. | In Slovenia one PCC (of all daytime centers) functions as out-of-hours center |
Deputizing services | Commercial agencies that employ GPs to take over duties of other GPs. | NHS direct is common in the United Kingdom |
Minor injury centers or walk-in-centers | Centers, which patients can visit without an appointment for minor injuries or illnesses in order to ask a trained nurse for health information, advice and treatment. | Ireland has a few privately organized models |
Hospital based and national models | ||
Telephone triage and advice services (TTA) | Patients have contact with a medically trained professional via a fixed, non-regional, telephone number. This person advises or refers the patient to the most suitable professional. | National call center in Portugal |
Emergency departments of hospitals (A&E) | Emergency departments of hospitals taking care of patients out-of-hours. | Unofficially used by patients in Belgium |
Primary out-of-hours care integrated in the hospital | Primary out-of-hours care integrated in the hospital (for example, in emergency departments). | Some experiments in Italy |