1 Department of Public Health - Forskningsenheden for Almen Praksis, Department of Public Health, Health, Aarhus University2 Department of Public Health - AU IT, Support, HE, Aarhus, Department of Public Health, Health, Aarhus University3 Department of Public Health - Forskningsenheden for Almen Praksis, Department of Public Health, Health, Aarhus University
Simulated Effects on Costs
Introduction. General practitioners (GP) answer calls to the Danish out-of-hours primary care service (OOH) in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We applied experiences from The Netherlands on nurse performance in the OOH triage concerning the number of calls per hour. Using the 2011 number of calls in one region, we examined three hypothetical scenarios with nurse triage and calculated the differences in fee costs. Results. A new organisation with 97 employed nurses would be needed. Fewer telephone consultations may result in an increase of face-to-face contacts, resulting in an increase of 23.6% in costs fees. Under optimal circumstances (e.g., a lower demand for OOH services, a high telephone termination rate, and unchanged GP fees) the costs could be reduced by 26.2% though excluding administrative costs of a new organisation. Conclusion. Substituting GPs with nurses in OOH primary care may increase the cost in fees compared to a model with only GPs. Further research is needed involving more influencing factors, such as costs due to nurse training and running the organisation.
International Journal of Family Medicine, 2013, Vol 2013, p. 1-5