Patient satisfaction with out-of-hours primary care in the Netherlands

From March to June 2003, 2805 questionnaires were sent to patients within three weeks after they had contacted the GP cooperative in their region. The study was conducted in the province of Limburg in the South of the Netherlands. One-third of these questionnaires was sent to patients who had only received telephone advice, one-third to patients who attended the GP cooperative for consultation, and one-third to patients who received a home visit. Four weeks after the first reminder, a non-respondents telephone interview was performed among a random sample of 100 patients. Analyses were performed with respect to the type of consultation.The total response was 42.4% (1160/2733). Sixty-seven percent of patients who received telephone advice only reported to be satisfied with out-of-hours care. About 80% of patients who went to the GP cooperative for consultation or those receiving a home visit, reported to be satisfied. Factors that were strongly associated with overall satisfaction included, the doctor's assistant's attitude on the phone, opinion on GP's treatment, and waiting time.Patients seem generally satisfied with out-of-hours primary care as organised in GP cooperatives. However, patients who received telephone advice only are less satisfied compared to those who attended the GP cooperative or those who received a home visit.In recent years, out-of-hours primary care in the Netherlands has been substantially reorganised. Formerly, general practitioners (GPs) used to perform these services in small locum groups (6 to 8 GPs) in which they joined a rota system. Nowadays, out-of-hours care is organised in large-scaled GP cooperatives (45 to 120 GPs) following examples in the UK and Denmark [1,2].The initiative of reorganising out-of-hours care has come mainly from the profession itself, motivated by increased dissatisfaction with the organisation of former out-of-hours primary care services. This dissatisfaction was mainly due to the high perceived workload (after