학술논문
Evaluation of telephone first approach to demand management in English general practice : observational study
Document Type
research-article
Author
Source
BMJ: British Medical Journal,
Subject
Language
English
ISSN
09598138
17561833
17561833
Abstract
To evaluate a “telephone first” approach, in which all patients wanting to see a general practitioner (GP) are asked to speak to a GP on the phone before being given an appointment for a face to face consultation.
Time series and cross sectional analysis of routine healthcare data, data from national surveys, and primary survey data.
147 general practices adopting the telephone first approach compared with a 10% random sample of other practices in England.
Management support for workload planning and introduction of the telephone first approach provided by two commercial companies.
Number of consultations, total time consulting (59 telephone first practices, no controls). Patient experience (GP Patient Survey, telephone first practices plus controls). Use and costs of secondary care (hospital episode statistics, telephone first practices plus controls). The main analysis was intention to treat, with sensitivity analyses restricted to practices thought to be closely following the companies’ protocols.
After the introduction of the telephone first approach, face to face consultations decreased considerably (adjusted change within practices −38%, 95% confidence interval −45% to −29%; P
The telephone first approach shows that many problems in general practice can be dealt with over the phone. The approach does not suit all patients or practices and is not a panacea for meeting demand. There was no evidence to support claims that the approach would, on average, save costs or reduce use of secondary care.
Time series and cross sectional analysis of routine healthcare data, data from national surveys, and primary survey data.
147 general practices adopting the telephone first approach compared with a 10% random sample of other practices in England.
Management support for workload planning and introduction of the telephone first approach provided by two commercial companies.
Number of consultations, total time consulting (59 telephone first practices, no controls). Patient experience (GP Patient Survey, telephone first practices plus controls). Use and costs of secondary care (hospital episode statistics, telephone first practices plus controls). The main analysis was intention to treat, with sensitivity analyses restricted to practices thought to be closely following the companies’ protocols.
After the introduction of the telephone first approach, face to face consultations decreased considerably (adjusted change within practices −38%, 95% confidence interval −45% to −29%; P
The telephone first approach shows that many problems in general practice can be dealt with over the phone. The approach does not suit all patients or practices and is not a panacea for meeting demand. There was no evidence to support claims that the approach would, on average, save costs or reduce use of secondary care.