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The Out-of-Hours (OOH) healthcare service, Lægevagten, in Denmark addresses acute illnesses that cannot wait for regular office hours, primarily offering treatment through General Practitioners (GPs). Available free of charge for most citizens, services operate from 16:00 to 08:00 on weekdays, as well as on Saturdays, Sundays, and public holidays. The OOH service provides phone consultations, home visits, and fully equipped consultation rooms. With public funding by the five regions of Denmark, it aims for timely and effective healthcare, while addressing challenges such as resource availability and patient expectations.
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Denmark • Organisation of the OOH-servicesLægevagten i Danmark • Aim: To treat acute conditions, mainly general illnesses which can not wait until ordinary hours – treatment by their own doctor • All contacts doctor visitated • Very acute conditions (Heart attacks and similar) normally direct to hospital or acute ambulance/doctor
Organisation of the OOH-servicesLægevagten i Danmark • General practise responsible • The Regions pay • Free - No payment for almost all citizens • 16.00 – 08.00 on weekdays All Saturday, Sundays and public holidays
The GPs role • Part of the GPs public agreement • The GP has to treat the patients 24 hours • In practice organised with public and GP run ”lægevagt” • The Region provide consultation rooms cars and the payment. The GP provide manpower. • Visitation only by specialists • GPs and other doctors for the other Posts
Public funding by the Regions • 5 Regions • Hovedstaden The capital, North Zealand and Bornholm Inhabitants 1.650.000 • Sjælland (rest of Zealand) 820.000 • South (Fuhnen and southern Jutland) 1.195.000 • Midt Middle (Central parts of Jutland) 1.237.000 • North (Northern parts of Jutland) 580.000
Functions • Visitation (phone consultations) By telephone give advice, medicine or decide for consultations or home visits (only by specialist in family medicine) • Consultation • aprox. 1o different consultations in each region • Home visits • aprox 10 cars in each region
Conditions . • Consultation rooms fully equipped No staff • Free cars with driver and computer • All functions electronic, communication between visitator and other doctors, pharmacies, messages is send to the patients doctor electronic (by phone to hospitals and ambulances)
Payment A 16-22 + Saturday B 22-08 + Sunday 0101. Consultation 175,93 218,43 0501. Telefonkonsultation uden besøg/konsultation 86,17 108,87 0602. Telefonkonsultation med besøg/konsultation 37,26 46,10 0471. Besøg 244,43 298,95 2302. Tillægstakst udover 10 km, pr. km 13,10 15,91
Challenges: Clinically • Continued clinical training • Homogeneity • In between areas • In between individual doctors • Andet????
Challenges: Expectations from the community • Distance to consultations • Available - without waiting time • Good quality • andet???
Challenges:Collaboration with other health services • In general very good • normally unproblematic • Normally will only the patients who need hospital treatment get in contact with hospitals (some geographic differences) • And the hospitals know it and appreciate it.
Challenges:in relation to organisation • Sufficient doctors in remote areas • Quality of consultation rooms • Staff • CME and CPD • Keep the expectations down • only treat the necessary • keep the rest for daytime or no treatment