De (patho)genese van de grootschalige dienstenstructuur
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- 作者：Rianne van den Berg (1)
Frans Meijman - 关键词：onderzoek ; dokterspost
- 刊名：Huisarts en wetenschap
- 出版年：2009
- 出版时间：April 2009
- 年：2009
- 卷：52
- 期：4
- 页码：177-181
- 全文大小：
- 作者单位：Rianne van den Berg (1)
Frans Meijman
1. www.bsl.nl/shop/stimulus-online-0929-0591-onl.html - ISSN：1876-5912
文摘
Van den Berg R, Meijman FJ. The (patho)genesis of the large-scale out of hours primary care centres. Huisarts Wet 2009;52(4):177-81 Aim To map the reasons for and causes of the large-scale out of hours service for GPs. Can we say that real changes have actually come about?Method We carried out an exploratory systematic literature search into the organisational developments in the world of general practice in the years both before and after the introduction of the large-scale service structure.Results In earlier times the GP was available for his patients 24 hours per day, 7 days per week. A change was introduced in 1941 with the creation of the first central service in The Hague that ensured medical care during the weekend. In the early decades the Dutch GPs were somewhat sceptical with regard to this new development but, with an interim step in 1979, as of the end of the twentieth century more central services were set up for evening, night and weekend surgeries. The large-scale service structure had become dominant.Conclusion The rise of the large-scale service structure can be ascribed to the increase in the GP? workload and the changing spirit of the times. Since the introduction of the central out of hours centres, the triple ideology of continuous, integrated and personal care has changed in the sense that the continuity of care is no longer provided by the patient? own GP but by the doctor? colleagues. Although the introduction of the central centres has ensured a diminution in the workload experienced by the doctor, the GPs are farming out an increasing number of tasks to locums. Out of hours the person of the doctor does not guarantee (any longer) continuity of care either as far as patient or GP is concerned.