Table 4.
Outcomes of OOHS contact
| Study | Service and setting | Outcomes as a % of OOHS contacts | |||
| Home visit | Centre visit | Telephone advice | Other | ||
| Heaney and Gorman21 | GP rota, Scotland | 63.0 | 8.0 | 29.0 | – |
| Hulland et al 94 | GP rota+deputising service, England (children under 5 years only) |
– | – | 34.0 | – |
| O’Donnell et al 22 | Cooperative, Scotland | 22.7 | 53.7 | 14.1 | Sent ambulance: 2.0 Did not attend: 4.5 |
| Salisbury et al 15 | Cooperatives, England and Scotland | 23.6 | 29.8 | 45.4 | Other (not stated): 1.2 |
| O’Reilly et al 30 | Cooperative, Northern Ireland | 19.0 | 27.0 | 54.0 | – |
| Payne and Jessopp90 | Telephone triage and advice service, England | 37.0 | Directed to GP, either OOHS or daytime: 29.0 Directed to ED: 6.0 Directed to community-based services: 6.0 Directed to ambulance services: 1.0 |
||
| Munro et al 52 | Cooperative, England | 14.2 | 42.5 | 43.3 | – |
| Pooley et al 96 | Cooperatives, England | 36.1 | 29.5 | 34.3 | – |
| van Uden et al 70 | Two cooperatives, the Netherlands | Site A: 13.4 Site B: 7.4 |
Site A: 47.6 Site B: 62.8 |
Site A: 39.0 Site B: 29.8 |
– |
| Bury et al 56 | Eleven cooperatives, Ireland | 12.3 | 53.8 | 34.0 | – |
| Moll van Charante et al 64 | Cooperative, the Netherlands | 9.4 | 41.7 | 36.6 | – |
| Hansen and Hunskaar 107 | Cooperative casualty clinics, Norway | 1.9 | 62.2 | 29.9 | Call-out of GP and ambulance: 2.1 Other: 3.9 |
| Margas et al 20 | GP deputising service, Poland | 9.8 | GP: 63.0 Nurse: 27.2 |
– | – |
| Richards et al 48 | Cooperative, England | Precontract: 41.7 Postcontract: 40.1 |
Precontract: 8.9 Postcontract: 11.0 |
Precontract: 36.3 Postcontract: 42.4 |
Referred to hospital: pre 2.0; post 2.2 Patient cancelled call: pre 0.3; post 1.1 Triaged then passed to in-hours service: pre 10.8; post 3.2 |
| Hansen et al 65 | Cooperative casualty clinics, Norway | 3.3 | 62.7 | 9.5 | Dealt with by nurses only: 24.0 |
| Eichler et al 103 | Cooperative, Switzerland | 61.3 | 24.8 | 13.9 | – |
| Philips et al 25 | Cooperative, Belgium | Pre co-op: 27.0 Post co-op: 16.0 |
Pre co-op: 73.0* Post co-op: 84.0* |
– | *GP consultation—unclear if face-to-face, or if telephone consultation included |
| Johansen et al 45 | Cooperative ‘casualty clinics’, Norway | 0.9 | 62.6 | 9.1 | Emergency call-out of GP: 1.8 Telephone advice from nurse: 18.2 Nurse consultation: 1.7 Other: 5.7 |
| Adam et al 50 | Cooperative, Scotland (cancer contacts only) |
71.0 | 6.0 | 22.0 | – |
| Flarup et al 41 | Cooperatives, Denmark | 9.2 | 19.8 | 42.1 | Telephone referrals to other services: 28.9 |
| Huibers et al 16 | Cooperatives, Denmark and the Netherlands | Denmark: 13.1 Netherlands: 10.2 |
Denmark: 28.4 Netherlands: 49.6 |
Denmark: 58.6 Netherlands: 40.3 |
– |
| Buja et al 44 | OOHS, Italy | 52.1* | * | 37.9 | *Home visits and centre visits combined Referred to ED: 9.2 Referred to other specialist: 0.8 |
| Cook et al 40 | Telephone triage and advice line, England (in-hours and out-of-hours period) |
– | – | – | Urgent redirect to ambulance service: 3.5 Urgent redirect to A&E: 8.6 Urgent redirect to GP service: 7.3 Non-urgent redirect to GP service: 9.9 See GP on same day: 12.1 Self-care advice: 27.9 Health or dental: 14.5 Other: 16.2 |
| de Bont et al 66 | Cooperative, the Netherlands (contacts for fever in children only) |
– | 70.0 | 30.0 | – |
| Elliott et al 17 | Telephone triage and advice service, Scotland (out-of-hours period only) |
12.2 | 34.1 | 10.2 | Ambulance called: 6.9 Advised/sent to ED: 5.8 Advised to contact daytime GP: 8.4 Advised to contact pharmacist: 2.3 Other: 20.2 |
| van Gils-van Rooij et al 27 | Urgent care collaboratives (UCC), the Netherlands | 5.1 | 43.8 | 29.5 | Treatment at ED: 21.6 |
| Gnani et al 105 | Urgent care centres, England (preschool children) |
– | – | – | Discharged home after attendance: 40.0 Discharged home with GP follow-up: 39.0 Referred to specialist: 11.0 Referred to ED: 8.0 Other: 2.0 |
| Huibers et al 92 | OOHS, Denmark | – | 40.8* | 59.2 | *Unclear if this includes both home visits and centre attendances |
| Thoresen et al 51 | Cooperative casualty clinics, Norway (focus on patients with cancer) |
Patients with cancer: 3.1 Non-cancer patients: 14.2 |
Patients with cancer: 42.4 Non-cancer patients: 67.0 |
Patients with cancer: 26.7 Non-cancer patients: 24.3 |
Simple contacts (no definition given) Patients with cancer: 2.6 Non-cancer patients: 2.2 Nursing service Patients with cancer: 2.6 Non-cancer patients: 2.2 |
| Hayward et al 67 | OOHS, England | – | – | – | No follow-up: 46.6 Own GP follow-up: 31.5 Acute referral to secondary care: 8.3 Referral to other service: 2.5 OOHS follow-up: 1.6 Failed encounter/not coded: 9.5 |
| Smits et al 8 | Cooperatives, the Netherlands | 10.0 | 50.0 | 40.0 | – |
| Brettell et al 85 | OOHS, England (focus on patients who died within 30 days of contact) |
Died within 30 days: 55.8 Alive within 30 days: 9.7 |
Died within 30 days: 4.2 Alive within 30 days: 55.8 |
Died within 30 days: 39.9 Alive within 30 days: 34.3 |
– |
| Lous et al 106 | OOHS, Denmark | 12.9 | 27.6 | 59.5 | – |
A&E, accident and emergency; ED, emergency department; GP, general practitioner; OOHS, out-of-hours health services.