OUT-OF-HOURS SERVICE - THE DANISH SOLUTION EXAMINED
OUT-OF-HOURS SERVICE - THE DANISH SOLUTION EXAMINED
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DOI：
10.1136/bmj.309.6969.1624
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发表时间：
1994-12-17
影响因子：
--
通讯作者：
JOLLEYS, JV
中科院分区：
文献类型：
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作者：
OLESEN, F;JOLLEYS, JV
在丹麦，20 世纪 80 年代，由于公众对服务的需求不断增长，以及农村医生对工作量过大且薪酬与城市医生相比过低的抱怨不断增加，全科医生提供的非工作时间护理面临着越来越大的压力。因此，1992 年初对非工作时间服务进行了改革：当地协商的轮值制度被县级服务所取代。现在每个县都有一个协调中心，所有患者的电话都由一组医生负责接收。医生可能会进行电话咨询，建议患者前往县内战略性设立的急诊诊所之一，或安排上门拜访。上门值班医生分布在全县各地基地，并通过手机与协调中心保持联系。分级收费意味着鼓励医生进行电话咨询，而不是安排诊所咨询或家访。这些改革减少了医生的非工作时间工作量和家访次数，并被证明为患者、医生和管理人员所接受。
In Denmark the provision of out of hours care by general practitioners came under increasing pressure in the 1980s because of growing demand for services by the public and increasing complaints from rural doctors about their heavy workload and disproportionately low remuneration in comparison with urban doctors. As a result, the out of hours service was reformed at the start of 1992: locally negotiated rota systems were replaced with county based services. Each county now has a coordination centre, where all patients' calls are received by a team of doctors. The doctors may give a telephone consultation, advise the patient to attend one of the emergency clinics strategically placed about the county, or arrange for a home visit. Doctors on home visiting duty are located at bases throughout the county and keep in touch with the coordination centre with mobile telephones. Graded fees mean that doctors are encouraged to give telephone consultations rather than arrange for clinic consultations or home visits. The reforms have reduced doctors' out of hours workload and the number of home visits made and have proved acceptable to patients, doctors, and administrators.