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Out-of-hours palliative care by General Practitioners.

Author: Bart Schweitzer

Date: 25-10-2012

Promotors:  Prof. dr. Henriëtte van der Horst and Prof. dr. Luc Deliens
Co-Promotor: Prof. dr. Nettie Blankenstein

Summary of the dissertation

Background
Out-of-hours GP care in England, Denmark and the Netherlands has been reorganised and is now provided by large scale GP co-operatives. Adequate transfer of information is necessary in order to assure continuity of care, which is of major importance in palliative care. We conducted a study to assess the availability, content and effect of information transferred to the GP co-operatives.

Methods
Cross-sectional exploratory study of all palliative care phone calls during a period of one year to a GP co-operative.

Results
The total number of phone calls about patients who needed palliative care was 0.75% of all calls to the GP co-operative. Information was transferred by GPs on 25.5% of palliative care patient calls, and on 12% of palliative care patient calls from residential care homes. For terminally ill patients the number of information transfers increased to 28.9%. When information was transferred, the content consisted mainly of clinical data. Information about the diagnosis and current problems was transferred in more than 90% of cases, information about the patient's wishes in 45% and information about the patient's psychosocial situation in 30.5% of cases.

A home visit was made after 53% of the palliative care calls.

When information was transferred, fewer patients were referred to a hospital.

Conclusion
GPs frequently fail to transfer information about their palliative care patients to the GP co-operatives. Locums working at the GP co-operative are thus required to provide palliative care in complex situations without receiving adequate information

GPs should be encouraged and trained to make this information available to the GP co-operatives.

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