Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands
ObjectiveTo provide insight into the motives for hospital self-referral during office hours and the barriers deterring general practitioner (GP) consultation with a primary care request.SettingPeople who self-referred at a Daytime General Practice Cooperative (GPC) in two hospitals in The Hague, The...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/6/e029853.full |
| _version_ | 1818956847054323712 |
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| author | Mattijs E Numans Rosa Naomi Minderhout Pien Venema Hedwig M M Vos Jojanneke Kant Marc Abraham Bruijnzeels |
| author_facet | Mattijs E Numans Rosa Naomi Minderhout Pien Venema Hedwig M M Vos Jojanneke Kant Marc Abraham Bruijnzeels |
| author_sort | Mattijs E Numans |
| collection | DOAJ |
| description | ObjectiveTo provide insight into the motives for hospital self-referral during office hours and the barriers deterring general practitioner (GP) consultation with a primary care request.SettingPeople who self-referred at a Daytime General Practice Cooperative (GPC) in two hospitals in The Hague, The Netherlands.ParticipantsA total of 44 people who self-referred were interviewed in two hospitals. The average age of interviewees was 35 years (range 19 months to 83 years), a parent of a young patient was interviewed, but the age of patients is shown here. There were more male patients (66%) than female patients (34%). Patients were recruited using a sampling method after triage. Triage was the responsibility of an emergency department (ED) nurse in one hospital and of a GP in the other. Those excluded from participation included (a) children under the age of 18 years and not accompanied by a parent or legal guardian, (b) foreign patients not resident in the Netherlands, (c) patients unable to communicate in Dutch or English and (d) patients directly referred to the ED after triage by the GP (in one hospital).ResultsPeople who self-referred generally reported several motives for going to the hospital directly. Information and awareness factors played an important role, often related to a lack of information regarding where to go with a medical complaint. Furthermore, many people who self-referred mentioned hospital facilities, convenience and perceived medical necessity as motivational factors. Barriers deterring a visit to the own GP were mainly logistical, including not being registered with a GP, the GP was too far away, poor GP telephone accessibility or a waiting list for an appointment.ConclusionInformation and awareness factors contribute to misperceptions among people who self-referred concerning the complaint, the GP and the hospital. As a range of motivational factors are involved, there is no straightforward solution. However, better dissemination of information might alleviate misconceptions and contribute to providing the right care to the right patient in the right setting. |
| first_indexed | 2024-12-20T11:00:27Z |
| format | Article |
| id | doaj.art-7a28061a96234564bd63d53e65dad63e |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-12-20T11:00:27Z |
| publishDate | 2019-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-7a28061a96234564bd63d53e65dad63e2022-12-21T19:43:02ZengBMJ Publishing GroupBMJ Open2044-60552019-06-019610.1136/bmjopen-2019-029853Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The NetherlandsMattijs E Numans0Rosa Naomi Minderhout1Pien Venema2Hedwig M M Vos3Jojanneke Kant4Marc Abraham Bruijnzeels53 Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands Department of Public Health and Primary Care/ LUMC-Campus, Leiden University Medical Centre, The Hague, NetherlandsDepartment of Public Health and Primary Care/ LUMC-Campus, Leiden University Medical Centre, The Hague, NetherlandsDepartment of Public Health and Primary Care, LUMC, Leiden, The NetherlandsSMASH, a General Practice Service, The Hague, NetherlandsDepartment of Public Health and Primary Care/ LUMC-Campus, Leiden University Medical Centre, The Hague, NetherlandsObjectiveTo provide insight into the motives for hospital self-referral during office hours and the barriers deterring general practitioner (GP) consultation with a primary care request.SettingPeople who self-referred at a Daytime General Practice Cooperative (GPC) in two hospitals in The Hague, The Netherlands.ParticipantsA total of 44 people who self-referred were interviewed in two hospitals. The average age of interviewees was 35 years (range 19 months to 83 years), a parent of a young patient was interviewed, but the age of patients is shown here. There were more male patients (66%) than female patients (34%). Patients were recruited using a sampling method after triage. Triage was the responsibility of an emergency department (ED) nurse in one hospital and of a GP in the other. Those excluded from participation included (a) children under the age of 18 years and not accompanied by a parent or legal guardian, (b) foreign patients not resident in the Netherlands, (c) patients unable to communicate in Dutch or English and (d) patients directly referred to the ED after triage by the GP (in one hospital).ResultsPeople who self-referred generally reported several motives for going to the hospital directly. Information and awareness factors played an important role, often related to a lack of information regarding where to go with a medical complaint. Furthermore, many people who self-referred mentioned hospital facilities, convenience and perceived medical necessity as motivational factors. Barriers deterring a visit to the own GP were mainly logistical, including not being registered with a GP, the GP was too far away, poor GP telephone accessibility or a waiting list for an appointment.ConclusionInformation and awareness factors contribute to misperceptions among people who self-referred concerning the complaint, the GP and the hospital. As a range of motivational factors are involved, there is no straightforward solution. However, better dissemination of information might alleviate misconceptions and contribute to providing the right care to the right patient in the right setting.https://bmjopen.bmj.com/content/9/6/e029853.full |
| spellingShingle | Mattijs E Numans Rosa Naomi Minderhout Pien Venema Hedwig M M Vos Jojanneke Kant Marc Abraham Bruijnzeels Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands BMJ Open |
| title | Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands |
| title_full | Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands |
| title_fullStr | Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands |
| title_full_unstemmed | Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands |
| title_short | Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands |
| title_sort | understanding people who self referred in an emergency department with primary care problems during office hours a qualitative interview study at a daytime general practice cooperative in two hospitals in the hague the netherlands |
| url | https://bmjopen.bmj.com/content/9/6/e029853.full |
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