Smits Marleen, Keizer Ellen, Huibers Linda, Giesen Paul
Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Nijmegen Medical Centre , Nijmegen , The Netherlands.
Eur J Gen Pract. 2014 Sep;20(3):196-201. doi: 10.3109/13814788.2013.839652. Epub 2013 Oct 25.
Out-of-hours primary care has been provided by general practitioner (GP) cooperatives since the year 2000 in the Netherlands. Early studies in countries with similar organizational structures showed positive GP experiences. However, nowadays it is said that GPs experience a high workload at the cooperative and that they outsource a considerable part of their shifts.
To examine positive and negative experiences of GPs providing out-of-hours primary care, and the frequency and reasons for outsourcing shifts.
A cross-sectional observational survey among 688 GPs connected to six GP cooperatives in the Netherlands, using a web-based questionnaire.
The response was 55% (n = 378). The main reasons for working in GP cooperatives were to retain registration as GP (79%) and remain experienced in acute care (74%). GPs considered the peak hours (81%) and the high number of patients (73%) as the most negative aspects. Most GPs chose to provide the out-of-hours shifts themselves: 85% outsourced maximally 25% of their shifts. The percentage of outsourced shifts increased with age. Main reasons for outsourcing were the desire to have more private time (76%); the high workload in daytime practice (71%); and less the workload during out-of-hours (46%).
GPs are motivated to work in out-of-hours GP cooperatives, and they outsource few shifts. GPs consider the peak load and the large number of (non-urgent) help requests as the most negative aspects. To motivate and involve GPs for 7 × 24-h primary care, it is important to set limits on their workload.
自2000年起，荷兰的非工作时间初级医疗服务由全科医生（GP）合作社提供。早期在组织结构类似国家的研究显示，全科医生对此体验良好。然而，如今据说全科医生在合作社工作量很大，并且他们会将相当一部分班次外包出去。
调查提供非工作时间初级医疗服务的全科医生的积极和消极体验，以及班次外包的频率和原因。
通过基于网络的问卷，对荷兰六个全科医生合作社的688名全科医生进行横断面观察性调查。
回复率为55%（n = 378）。在全科医生合作社工作的主要原因是保持全科医生注册资格（79%）以及保持急性护理方面的经验（74%）。全科医生认为高峰时段（81%）和患者数量多（73%）是最消极的方面。大多数全科医生选择自己提供非工作时间的班次：85%最多外包25%的班次。外包班次的比例随年龄增加。外包的主要原因是希望有更多私人时间（76%）；日间工作时工作量大（71%）；以及非工作时间工作量相对较小（46%）。
全科医生有动力在非工作时间的全科医生合作社工作，并且他们外包的班次很少。全科医生认为高峰负荷和大量（非紧急）求助请求是最消极的方面。为激励全科医生参与7×24小时初级医疗服务，限制他们的工作量很重要。
