APPRAISAL OF FIVE NEW OUT-OF-HOURS (OOH) PRIMARY CARE CENTRES IN THE PARISIAN REGION- “MAISONS MÉDICALES DE GARDE (MMG)”

Author(s)

Lemasson H1, Jasso Mosqueda J2, Chicoye A21AREMIS Consultants, Neuilly Sur Seine, Ile de France, France; 2 AREMIS Consultants, Neuilly Sur Seine, France

French GPs are increasing reluctant to dispense medical services in OOH because of security concerns and lack of economic incentives. In order to motivate GPs to participate to OOH care, experimental MMGs have been set up. A medical office is shared by GPs on duty to provide medical services in predetermined time schedules. Referrals to MMG are determined by emergency dispatching centres (C15) and/or hospital emergency departments (HED). GPs receive a forfeit, adjusted with effectively dispensed visits. Facilities are secured. OBJECTIVES: To assess the 5 MMG activity in comparison to HED, C15 and other home cares and patients and professionals satisfaction. METHODS: “Before-after” assessment month 2 to 6 after MMGs were set up and reproduced at month 14 to 18. Quantitative data were collected from MMGs, “C15”, HED and health insurance. Questionnaires were submitted to patients (visiting/calling HED, “C15”, GPs practices or MMG, n = 537), and professionals (GPs involved in MMGs, HED and C15 professionals n = 389). RESULTS: Half of the practitioners in MMGs area participated. Most patients (95%) were in need of primary care. On weekend days, number of visits to MMG were approximately equivalent or superior to an office based GP (22), but on weekdays (8pm-12pm) average number of visits was low (<4). Patients and GPs were satisfied with services. MMGs however can not meet all OOH needs, particularly home visits. Although they differ in organisation, there is room for optimization for all MMGs. Professionals are unable to define precisely OOH primary care, and communication to patients, highly desirable, is not yet harmonized. CONCLUSION: MMG should be encouraged but provide only partial response, as a global approach including home visits is needed.

Conference/Value in Health Info

2005-11, ISPOR Europe 2005, Florence, Italy

Value in Health, Vol. 8, No.6 (November/December 2005)

Code

PHP45

Topic

Health Policy & Regulatory

Topic Subcategory

Approval & Labeling

Disease

Multiple Diseases

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