Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Care | Research article

Factors related to out-of-hours help-seeking for acute health problems: a survey study using case scenarios

Authors: Ellen Keizer, Morten Bondo Christensen, Anders Helles Carlsen, Marleen Smits, Michel Wensing, Oliver Senn, Linda Huibers

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

The acute out-of-hours healthcare services are challenged by increasing demand in many countries. We aimed to examine factors influencing the intended help-seeking in out-of-hours care for acute health problems during evenings, nights, and weekends.

Methods

We conducted a survey study based on data from parents of children (aged 0–4 years) and adults (aged 30–39 and 50–59 years) in Denmark, the Netherlands and Switzerland. Intended help-seeking behaviour was measured by six hypothetical case scenarios. We used Andersen’s Behavioural Model to categorise potentially influential factors and applied multiple binomial regression to assess the influence of selected factors.

Results

A total of 1015 parents and 2942 adults participated. We identified several significant influential factors. Parents holding a low education (OR 1.56), having migrant background (western: OR 1.23; non-western: OR 1.93), having one child (OR 1.24), perceiving few barriers to using out-of-hours primary care (OR 1.59), perceiving difficulties with organising childcare (OR 1.13), and having a history of frequent contacts with out-of-hours care (OR 1.55) were more inclined to contact out-of-hours care, whereas female (OR 0.85) and non-anxious parents (OR 0.77) were less inclined. Adults who were older (OR 1.01), holding a medical education (OR 1.13), having non-western background (OR 1.28), being unemployed (OR 1.17), perceiving few barriers to using out-of-hours primary care (OR 1.37), and having a history of frequent contacts with a GP (few: OR 1.15; more: OR 1.22) and/or with out-of-hours care (one: OR 1.20; more: OR 1.49) were more inclined to contact out-of-hours care, whereas adults with no or little social support (OR 0.84) and adults with high health literacy level on health information (OR 0.91) were less inclined. Dutch parents were less inclined than Danish parents to contact out-of-hours care (OR 0.62), whereas Swiss adults were more inclined than Danish adults to contact out-of-hours care (OR 1.16).

Conclusion

We identified several factors related to intended help-seeking in out-of-hours care. These results could be used to develop targeted interventions, but more research is needed to examine the underlying explanations for the identified differences.
Appendix
Available only for authorised users
Literature
1.
Carter EJ, Pouch SM, Larson EL. The relationship between emergency department crowding and patient outcomes: a systematic review. J Nurs Scholarsh. 2014;46(2):106–15.CrossRef
2.
Smits M, Rutten M, Keizer E, Wensing M, Westert G, Giesen P. The development and performance of after-hours primary Care in the Netherlands: a narrative review. Ann Intern Med. 2017;166(10):737–42.CrossRef
3.
Keizer E, Smits M, Peters Y, Huibers L, Giesen P, Wensing M. Contacts with out-of-hours primary care for nonurgent problems: patients' beliefs or deficiencies in healthcare? BMC Fam Pract. 2015;16(1):157.CrossRef
4.
Hugenholtz M, Broer C, van Daalen R. Apprehensive parents: a qualitative study of parents seeking immediate primary care for their children. Br J Gen Pract. 2009;59(560):173–9.CrossRef
5.
Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Emergency department visits for nonurgent conditions: systematic literature review. Am J Manag Care. 2013;19(1):47–59.PubMedPubMedCentral
6.
Durand AC, Gentile S, Devictor B, Palazzolo S, Vignally P, Gerbeaux P, Sambuc R. ED patients: how nonurgent are they? Systematic review of the emergency medicine literature. Am J Emerg Med. 2011;29(3):333–45.CrossRef
7.
Thijssen WA, van Mierlo E, Willekens M, Rebel J, Sandel MH, Giesen P, Wensing M. Complaints and diagnoses of emergency department patients in the Netherlands: a comparative study of integrated primary and emergency care. PLoS One. 2015;10(7):e0129739.CrossRef
8.
Huibers L, Moth G, Carlsen AH, Christensen MB, Vedsted P. Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance. Br J Gen Pract. 2016;66(650):e667–73.CrossRef
9.
van Loenen T, van den Berg MJ, Faber MJ, Westert GP. Propensity to seek healthcare in different healthcare systems: analysis of patient data in 34 countries. BMC Health Serv Res. 2015;15(1):465.CrossRef
10.
Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10.CrossRef
11.
Padgett DK, Brodsky B. Psychosocial factors influencing non-urgent use of the emergency room: a review of the literature and recommendations for research and improved service delivery. Soc Sci Med. 1992;35(9):1189–97.CrossRef
12.
McCusker J, Karp I, Cardin S, Durand P, Morin J. Determinants of emergency department visits by older adults: a systematic review. Acad Emerg Med. 2003;10(12):1362–70.CrossRef
13.
Huibers L, Keizer E, Carlsen AH, Moth G, Smits M, Senn O, Christensen MB. Help-seeking behaviour outside office hours in Denmark, the Netherlands and Switzerland: a questionnaire study exploring responses to hypothetical cases. BMJ Open. 2018;8(10):e019295.CrossRef
14.
Huibers L, Philips H, Giesen P, Remmen R, Christensen MB, Bondevik GT. EurOOHnet-the European research network for out-of-hours primary health care. Eur J Gen Pract. 2014;20(3):229–32.CrossRef
15.
Keizer E, Huibers L, Christensen MB, Senn O: The Impact of alternative healthcare plans on out-of-hours help-seeking intentions in Switzerland Swiss Med Wkly 2018, 148(w414686).
16.
Huibers L, Moth G, Andersen M, van Grunsven P, Giesen P, Christensen MB, Olesen F. Consumption in out-of-hours health care: Danes double Dutch? Scand J Prim Health Care. 2014;32(1):44–50.CrossRef
17.
Smits M, Hanssen S, Huibers L, Giesen P. Telephone triage in general practices: a written case scenario study in the Netherlands. Scand J Prim Health Care. 2016;34(1):28–36.CrossRef
18.
Giesen P, Ferwerda R, Tijssen R, Mokkink H, Drijver R, van den Bosch W, Grol R. Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency? Qual Saf Health Care. 2007;16(3):181–4.CrossRef
19.
Huibers L, Sloot S, Giesen P, van Veen M, van Ierland Y, Moll H: Wetenschappelijk onderzoek Nederlands Triage Systeem [Scientific Research Netherlands Triage System]. In. Nijmegen, Rotterdam: IQ healthcare Radboudumc, Erasmus MC Sophia Kinderziekenhuis; 2009.
20.
Beaton D, Bombardier C, Guillemin F, Ferraz M. Recommendations for the cross-cultural adaptation of the DASH and quick DASH outcome measures. Toronto: Institute for Work and Health; 2007.
21.
Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146(5):317–25.CrossRef
22.
Schwarzer R, Jerusalem M. Generalized self-efficacy scale. In: Winman J, Wright S, Johnston M, editors. Measures in health psychology: A user's portfolio Causal and control beliefs. Windsor, England: NFER-NELSON; 1995. p. 35–7.
23.
Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R. The grounded psychometric development and initial validation of the health literacy questionnaire (HLQ). BMC Public Health. 2013;13:658.CrossRef
24.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRef
25.
Larsen MB, Hansen RP, Sokolowski I, Vedsted P. Agreement between patient-reported and doctor-reported patient intervals and date of first symptom presentation in cancer diagnosis - a population-based questionnaire study. Cancer Epidemiol. 2014;38(1):100–5.CrossRef
26.
Christensen AI, Ekholm O, Glumer C, Andreasen AH, Hvidberg MF, Kristensen PL, Larsen FB, Ortiz B, Juel K. The Danish National Health Survey 2010. Study design and respondent characteristics. Scand J Public Health. 2012;40(4):391–7.CrossRef
27.
Zwaanswijk M, Nielen MM, Hek K, Verheij RA. Factors associated with variation in urgency of primary out-of-hours contacts in the Netherlands: a cross-sectional study. BMJ Open. 2015;5(10):e008421.CrossRef
28.
Woolfenden S, Ritchie J, Hanson R, Nossar V. Parental use of a paediatric emergency department as an ambulatory care service. Aust N Z J Public Health. 2000;24(2):204–6.CrossRef
29.
Smits M, Peters Y, Broers S, Keizer E, Wensing M, Giesen P. Association between general practice characteristics and use of out-of-hours GP cooperatives. BMC Fam Pract. 2015;16(52).
30.
Raknes G, Hansen EH, Hunskaar S. Distance and utilisation of out-of-hours services in a Norwegian urban/rural district: an ecological study. BMC Health Serv Res. 2013;13(1):222.CrossRef
31.
Benahmed N, Laokri S, Zhang WH, Verhaeghe N, Trybou J, Cohen L, De Wever A, Alexander S. Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium. Eur J Pediatr. 2012;171(12):1829–37.CrossRef
32.
Cornford CS, Cornford HM. I'm only here because of my family. a study of lay referral networks. Br J Gen Pract. 1999;49:617–20.PubMedCentral
33.
Jorgensen JT, Andersen JS, Tjonneland A, Andersen ZJ. Determinants of frequent attendance in Danish general practice: a cohort-based cross-sectional study. BMC Fam Pract. 2016;17:9.CrossRef
34.
Armitage CJ, Conner M. Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol. 2001;40(Pt 4):471–99.CrossRef
35.
Hunt K, Adamson J, Hewitt C, Nazareth I. Do women consult more than men? A review of gender and consultation for back pain and headache. J Health Serv Res Policy. 2011;16(2):108–17.CrossRef
36.
Singer E, Ye C. The use and effects of incentives in surveys. The Annals of the American Academy of Political and Social Science. 2013;645(1):112–41.CrossRef
37.
Van den Heede K, Van de Voorde C. Interventions to reduce emergency department utilisation: a review of reviews. Health Policy. 2016;120(12):1337–49.CrossRef
38.
Giesen MJ, Keizer E, van de Pol J, Knoben J, Wensing M, Giesen P. The impact of demand management strategies on parents' decision-making for out-of-hours primary care: findings from a survey in the Netherlands. BMJ Open. 2017;7(5):e014605.CrossRef
39.
40.
Metadata
Title
Factors related to out-of-hours help-seeking for acute health problems: a survey study using case scenarios
Authors
Ellen Keizer
Morten Bondo Christensen
Anders Helles Carlsen
Marleen Smits
Michel Wensing
Oliver Senn
Linda Huibers
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-6332-6

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue

Research article

A generalized additive model to disentangle age and diagnosis-specific cohort effects in psychological and behavioral outcomes in people living with HIV: the French cross-sectional ANRS-VESPA2 survey

Research article

Should I sit or stand: likelihood of adherence to messages about reducing sitting time

Research article

Oral and anal high-risk human papilloma virus infection in HIV-positive men who have sex with men over a 24-month longitudinal study: complexity and vaccine implications

Research article

The association between residential density and physical activity among urban adults in regional China

Study protocol

The FANMI (“my FAMILY” in Creole) study to evaluate community-based cohort care for adolescent and young women living with HIV in Haiti: protocol for a randomized controlled trial

Study protocol

Anemia prevalence and etiology among women, men, and children in Ethiopia: a study protocol for a national population-based survey