After-hours calls: a five-year longitudinal study in a family practice group

Area of Science:

• Family Medicine
• Primary Care Practice Management

Background:

• Providing health care outside regular hours is a significant challenge in primary care.
• After-hours care is a crucial component of family medicine residency training.

Purpose of the Study:

• To analyze the volume and patterns of after-hours calls in a residency-based family practice over five years.
• To assess the impact of practice growth and maturation on after-hours care utilization.

Main Methods:

• A longitudinal study examining after-hours calls, patient visits, and hospitalizations.
• Data collected at the end of the first and fifth year of practice existence.
• Analysis of call distribution, reasons for calls, and resident consultation rates.

Main Results:

• Over five years, patient numbers tripled, scheduled visits doubled, and after-hours calls, visits, and hospitalizations increased by 40%, 70%, and 50%, respectively.
• After-hours utilization decreased relative to practice volume, indicating practice maturation reduces unscheduled demand.
• Despite this, the absolute burden of after-hours calls increased due to overall practice growth. Residents managed most calls independently.

Conclusions:

• Practice maturation can decrease unscheduled after-hours demand, but overall growth necessitates increased after-hours resources.
• The patterns of after-hours utilization are consistent with findings from other primary care studies.
• Effective management of after-hours care is essential for primary care practices, especially in residency settings.