Use of out-of-hours services: the patient's point of view on co-payment a mixed methods approach

Introduction: In many countries out of hours (OOH);,care is offered by different :health care services. General; practitioners (GP); tend to offer services in competition with emergency departments (ED). Patients behaviour : depends on a number of factors. In this study, we highlight the knowledge and ideas of patients concerning the co-payment system. Methods: We used a mixed methods design, combining quantitative-and qualitative research. During two week-ends in January 2005 all patients using the ED or the GP OOH service, were invited for an interview with a structured questionnaire. A-stratified random sample of patients participated; in a semi-structured interview. Both methods add-complementary data to answer the research-questions. Results:, Most Mentioned reasons-for seeking help at the ED are: accessibility (15.0%), proximity (64%) and; competence of the Staff (5.6%). Reasons for choosing the GP are; GP: is easy to find; Minor medical problem or anxiety and confidence in the GP The Odds of not knowing the. co-payment system are significantly higher in patients visiting the ED (OR 1:783; 95% CI: 1.493-2.129). Mostly GP users recognize the problem of ED overuse. They suggested especially to provide clear information about the tasks of the different:services and about the payment system, to reduce ED overuse, Conclusion and discussion; When intending to. shift from;ED to GP services for Minor medical problems, aiming at just one measure is no option. Information campaigns. aiming to :address the entire population; Can clarify the role of each player in Out-of-hours care.