The after-hours call in family practice

Area of Science:

• Family Medicine
• Primary Care
• Healthcare Management

Background:

• After-hours patient care remains crucial for family physicians, despite rising Emergency Room use.
• Understanding after-hours care involves examining its definition, patient demographics, utilization patterns, and associated morbidities.

Purpose of the Study:

• To review the existing literature on after-hours care in family practice.
• To analyze data from a two-year period on after-hours calls within a Family Practice Residency Program.

Main Methods:

• Literature review covering definition, demography, utilization, morbidity, and patient stereotypes.
• Analysis of 4,760 after-hours calls recorded by residents and faculty physicians.
• Patient survey to assess congruence in reasons for after-hours calls.

Main Results:

• The overall call rate was 474 per 1,000 patients annually.
• 72% of calls were resolved via telephone, with consistent handling across age groups.
• Fever and skin wounds were common symptoms; respiratory infections, minor trauma, and anxiety were frequent diagnoses.
• Physician frustration occurred in 13% of contacts.
• Over 30% of patient calls showed a discrepancy between physician and patient-perceived reasons for the call.

Conclusions:

• Telephone management is effective for a majority of after-hours family practice calls.
• Physician-patient communication gaps exist regarding the necessity of after-hours contact.
• Further research may improve after-hours care efficiency and patient-physician alignment.