After-hours care in the United kingdom, Denmark, and the Netherlands: new models.

Abstract

There are indications that after-hours care in some countries is of poor quality. European after-hours care is shifting away from individual and group practices with local after-hours call schedules toward large-scale after-hours care services. Experiences with primary care cooperatives in three countries show that this model can lighten physicians' workloads, reduce the number of face-to-face contacts, reduce use of emergency services and hospital admissions, and lower costs. Most patients accept these new models but are dissatisfied if they expect to see a physician. Local or regional integration of all emergency services seems to be the most promising model for after-hours care.