Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study

Marloes Heutmekers, Jenneken Naaldenberg, Sabine A. Verheggen, Willem J.J. Assendelft, Henny M.J. van Schrojenstein Lantman-de Valk, Hilde Tobi, Geraline L. Leusink

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)

Abstract

Objectives: To investigate whether people with intellectual disabilities (ID) in residential setting were more likely than people from the general population to request out-of-hours general practitioner (GP) care and whether these requests had a similar level of urgency. Design: Cross-sectional routine data-based study. Setting: Two GP cooperatives providing out-of-hours primary care in an area in the Netherlands. Population: 432 582 persons living in the out-of-hours service areas, of which 1448 could be identified as having an ID. Main outcome measures: GP cooperative records of all contacts in 2014 for people with and without ID were used to calculate the relative risk of requesting care and the associated level of urgency. Results: Of the people with ID (448/1448), 30.9% requested out-of-hours GP care, whereas for the general population this was 18.4% (79 206/431 134), resulting in a relative risk of 1.7 (95% CI 1.6 to 1.8). We found a different distribution of urgency level for people with and without ID. Generally, requests for people with ID were rated as less urgent. Conclusion: People with ID in residential setting were more likely to request out-of-hours GP care than the general population. The distribution of the urgency level of requests differed between the two groups. The high percentage of demands relating to people with ID requesting counselling and advice suggests that some out-of-hours GP care may be avoidable. However, more insight is needed into the nature of out-of-hours primary care requests of people with ID to direct structural and reasonable adjustments towards the improvement of health information exchange in and around-the-clock access to primary care for people with ID.
Original languageEnglish
Article numbere019222
JournalBMJ Open
Volume7
Issue number11
DOIs
Publication statusPublished - 3 Nov 2017

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Disabled Persons
Intellectual Disability
Netherlands
General Practitioners
Population
Primary Health Care
Social Adjustment
Counseling
Outcome Assessment (Health Care)

Keywords

  • After-hours care
  • general practice
  • health equity
  • intellectual disabilities
  • primary healthcare
  • triage

Cite this

Heutmekers, Marloes ; Naaldenberg, Jenneken ; Verheggen, Sabine A. ; Assendelft, Willem J.J. ; van Schrojenstein Lantman-de Valk, Henny M.J. ; Tobi, Hilde ; Leusink, Geraline L. / Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study. In: BMJ Open. 2017 ; Vol. 7, No. 11.
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title = "Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study",
abstract = "Objectives: To investigate whether people with intellectual disabilities (ID) in residential setting were more likely than people from the general population to request out-of-hours general practitioner (GP) care and whether these requests had a similar level of urgency. Design: Cross-sectional routine data-based study. Setting: Two GP cooperatives providing out-of-hours primary care in an area in the Netherlands. Population: 432 582 persons living in the out-of-hours service areas, of which 1448 could be identified as having an ID. Main outcome measures: GP cooperative records of all contacts in 2014 for people with and without ID were used to calculate the relative risk of requesting care and the associated level of urgency. Results: Of the people with ID (448/1448), 30.9{\%} requested out-of-hours GP care, whereas for the general population this was 18.4{\%} (79 206/431 134), resulting in a relative risk of 1.7 (95{\%} CI 1.6 to 1.8). We found a different distribution of urgency level for people with and without ID. Generally, requests for people with ID were rated as less urgent. Conclusion: People with ID in residential setting were more likely to request out-of-hours GP care than the general population. The distribution of the urgency level of requests differed between the two groups. The high percentage of demands relating to people with ID requesting counselling and advice suggests that some out-of-hours GP care may be avoidable. However, more insight is needed into the nature of out-of-hours primary care requests of people with ID to direct structural and reasonable adjustments towards the improvement of health information exchange in and around-the-clock access to primary care for people with ID.",
keywords = "After-hours care, general practice, health equity, intellectual disabilities, primary healthcare, triage",
author = "Marloes Heutmekers and Jenneken Naaldenberg and Verheggen, {Sabine A.} and Assendelft, {Willem J.J.} and {van Schrojenstein Lantman-de Valk}, {Henny M.J.} and Hilde Tobi and Leusink, {Geraline L.}",
year = "2017",
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Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study. / Heutmekers, Marloes; Naaldenberg, Jenneken; Verheggen, Sabine A.; Assendelft, Willem J.J.; van Schrojenstein Lantman-de Valk, Henny M.J.; Tobi, Hilde; Leusink, Geraline L.

In: BMJ Open, Vol. 7, No. 11, e019222, 03.11.2017.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study

AU - Heutmekers, Marloes

AU - Naaldenberg, Jenneken

AU - Verheggen, Sabine A.

AU - Assendelft, Willem J.J.

AU - van Schrojenstein Lantman-de Valk, Henny M.J.

AU - Tobi, Hilde

AU - Leusink, Geraline L.

PY - 2017/11/3

Y1 - 2017/11/3

N2 - Objectives: To investigate whether people with intellectual disabilities (ID) in residential setting were more likely than people from the general population to request out-of-hours general practitioner (GP) care and whether these requests had a similar level of urgency. Design: Cross-sectional routine data-based study. Setting: Two GP cooperatives providing out-of-hours primary care in an area in the Netherlands. Population: 432 582 persons living in the out-of-hours service areas, of which 1448 could be identified as having an ID. Main outcome measures: GP cooperative records of all contacts in 2014 for people with and without ID were used to calculate the relative risk of requesting care and the associated level of urgency. Results: Of the people with ID (448/1448), 30.9% requested out-of-hours GP care, whereas for the general population this was 18.4% (79 206/431 134), resulting in a relative risk of 1.7 (95% CI 1.6 to 1.8). We found a different distribution of urgency level for people with and without ID. Generally, requests for people with ID were rated as less urgent. Conclusion: People with ID in residential setting were more likely to request out-of-hours GP care than the general population. The distribution of the urgency level of requests differed between the two groups. The high percentage of demands relating to people with ID requesting counselling and advice suggests that some out-of-hours GP care may be avoidable. However, more insight is needed into the nature of out-of-hours primary care requests of people with ID to direct structural and reasonable adjustments towards the improvement of health information exchange in and around-the-clock access to primary care for people with ID.

AB - Objectives: To investigate whether people with intellectual disabilities (ID) in residential setting were more likely than people from the general population to request out-of-hours general practitioner (GP) care and whether these requests had a similar level of urgency. Design: Cross-sectional routine data-based study. Setting: Two GP cooperatives providing out-of-hours primary care in an area in the Netherlands. Population: 432 582 persons living in the out-of-hours service areas, of which 1448 could be identified as having an ID. Main outcome measures: GP cooperative records of all contacts in 2014 for people with and without ID were used to calculate the relative risk of requesting care and the associated level of urgency. Results: Of the people with ID (448/1448), 30.9% requested out-of-hours GP care, whereas for the general population this was 18.4% (79 206/431 134), resulting in a relative risk of 1.7 (95% CI 1.6 to 1.8). We found a different distribution of urgency level for people with and without ID. Generally, requests for people with ID were rated as less urgent. Conclusion: People with ID in residential setting were more likely to request out-of-hours GP care than the general population. The distribution of the urgency level of requests differed between the two groups. The high percentage of demands relating to people with ID requesting counselling and advice suggests that some out-of-hours GP care may be avoidable. However, more insight is needed into the nature of out-of-hours primary care requests of people with ID to direct structural and reasonable adjustments towards the improvement of health information exchange in and around-the-clock access to primary care for people with ID.

KW - After-hours care

KW - general practice

KW - health equity

KW - intellectual disabilities

KW - primary healthcare

KW - triage

U2 - 10.1136/bmjopen-2017-019222

DO - 10.1136/bmjopen-2017-019222

M3 - Article

VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 11

M1 - e019222

ER -