Out-of-hours service in Denmark: the effect of a structural change

Area of Science:

• Healthcare policy
• General practice
• Public health

Background:

• The Danish out-of-hours general practitioner (GP) care system was reformed in 1992, transitioning from local rota systems to county-based services.
• This reform led to a significant reduction in the number of GPs on call.

Purpose of the Study:

• To evaluate patient experiences and satisfaction with the reformed out-of-hours GP care.
• To analyze changes in patient contact patterns and GP fees following the system overhaul.

Main Methods:

• A longitudinal questionnaire study assessed patient satisfaction at three time points: pre-reform, immediately post-reform, and three years later.
• Data on patient contacts and GP fees were extracted from the National Health Service Registry for 1991, 1992, and 1995.

Main Results:

• Patient contacts decreased by 16% in the first year and 6% by the third year.
• Telephone consultations more than doubled, while home visits reduced to one-third of previous levels.
• GP fees decreased by 20% over three years, and patient satisfaction saw a significant but diminishing decline.

Conclusions:

• The out-of-hours care reform achieved significant cost-effectiveness benefits.
• The reform resulted in a trade-off, with a decrease in patient satisfaction despite overall high levels and eventual recovery.