Out-of-hours doctors' decisions on call-outs in emergency situations

Area of Science:

• Emergency medicine
• Primary health care
• Medical decision-making

Background:

• Out-of-hours primary care physicians participate in emergency call-outs to varying degrees.
• The decision to perform a call-out rests with the out-of-hours doctor.
• Previous studies show varied participation in emergency call-outs by primary care physicians.

Purpose of the Study:

• To investigate the assessments guiding out-of-hours doctors' decisions on emergency call-outs.
• To understand the factors influencing the decision to respond to emergency incidents.

Main Methods:

• Interviews were conducted with out-of-hours doctors in Hordaland county.
• Interviews were linked to specific emergency incidents during evening/night shifts (excluding weekends).
• The study period was from July to October 2012.

Main Results:

• Out of 252 incidents, 72 were investigated, with 47 doctors interviewed (49% response rate).
• Doctors initiated call-outs in 65% of incidents.
• Patient's medical condition primarily drove decisions to call out; practicalities often led to non-response. Patient's need for medical expertise was key when call-outs were deemed necessary.

Conclusions:

• The decision to perform a call-out involves balancing patient needs with practical feasibility.
• Out-of-hours doctors frequently perceive a need for medical expertise in emergency scenarios.
• A comprehensive assessment of patient requirements and logistical constraints informs call-out decisions.