To compare the process of out of hours care provided by general practitioners from patients'own practices and by commercial deputising services.
Randomised controlled trial.
Four urban areas in Manchester, Salford, Stockport, and Leicester.
2152 patients who requested out of hours care, and 49 practice doctors and 183 deputising doctors (61% local principals) who responded to those requests.
Response to call, time to visit, prescribing, and hospital admissions.
1046 calls were dealt with by practice doctors and 1106 by deputising doctors.
Practice doctors were more likely to give telephone advice (20.2% v 0.72% of calls) and to visit more quickly than deputising doctors (median delay 35 minutes v 52 minutes).
Practice doctors were less likely than deputising doctors to issue a prescription (56.1% v 63.2% of patients) or to prescribe an antibiotic (43.7% v 61.3% of prescriptions issued) and more likely to prescribe generic drugs (58.4% v 32.1% of drugs prescribed), cheaper drugs (mean cost per prescription £3.28 v £5.04), and drugs in a predefined out of hours formulary (49.8% v 41.1% of drugs prescribed).
There was no significant difference in the number of hospital admissions. (...)
Mots-clés Pascal : Qualité, Soin, Médecin généraliste, Prescription, Hospitalisation, Consultation, Etude comparative, Homme, Essai clinique
Mots-clés Pascal anglais : Quality, Care, General practitioner, Prescription, Hospitalization, Consultation, Comparative study, Human, Clinical trial
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0156270
Code Inist : 002B30A01A2. Création : 21/05/1997.