Who attends out-of-hours general practice appointments? Analysis of a patient cohort accessing new out-of-hours units

KELLY, Shona, PIERCY, Hilary, IBBOTSON, Rachel and FOWLER-DAVIS, Sally (2018). Who attends out-of-hours general practice appointments? Analysis of a patient cohort accessing new out-of-hours units. BMJ Open, 8 (6), e020308.

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Official URL: http://bmjopen.bmj.com/content/8/6/e020308
Link to published version:: https://doi.org/10.1136/bmjopen-2017-020308

Abstract

Objectives This report describes the patients who used additional out-of-hours (OOH) appointments offered through a UK scheme intended to increase patient access to primary care by extending OOH provision. Design Cohort study and survey data. Setting OOH appointments offered in four units in one region in England (October 2015 to November 2016). Methods Unidentifiable data on all patients were abstracted from a bespoke appointment system and the responses to a patient opinion questionnaire about this service. Descriptive analysis of the appointment data was conducted. Multivariate analysis of the opinion survey data examined the characteristics of the patients who would have gone to the emergency department (ED) had the OOH appointments not been available. Results There were 24 448 appointments for 19 701 different patients resulting in 29 629 service outcomes. Women dominated the uptake and patients from the poorest fifth of the population used nearly 40% of appointments. The patient survey found OOH appointments were extremely popular—93% selecting ‘extremely likely’ or ‘likely’ to recommend the service. Multivariate analysis of patient opinion survey data on whether ED would have been an alternative to the OOH service found that men, young children, people of Asian heritage and the most deprived were more likely to have gone to ED without this service. Conclusions The users of the OOH service were substantially different from in-hours service users with a large proportion of children under age 5, and the poor, which support the idea that there may be unmet need as the poor have the least flexible working conditions. These results demonstrate the need for equality impact assessment in planning service improvements associated with policy implementation. It suggests that OOH need to take account of patients expectations about convenience of appointments and how patients use services for urgent care needs.

Item Type: Article
Additional Information: ** From BMJ via Jisc Publications Router. ** History: received 30-10-2017; rev-recd 11-04-2018; accepted 13-04-2018; ppub 06-2018; epub 09-06-2018. ** Licence for this article: http://creativecommons.org/licenses/by-nc/4.0/
Uncontrolled Keywords: General practice / Family practice, 1506, 1696, general practice, primary care, out of hours appointments, patient characteristics
Research Institute, Centre or Group: Centre for Health and Social Care Research
Identification Number: https://doi.org/10.1136/bmjopen-2017-020308
Related URLs:
SWORD Depositor: Margaret Boot
Depositing User: Margaret Boot
Date Deposited: 12 Jun 2018 08:50
Last Modified: 16 Nov 2018 14:19
URI: http://shura.shu.ac.uk/id/eprint/21556

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