Aanvullende diagnostiek op Nederlandse huisartsenpost

Objective

To determine GPs’ access to diagnostic tests (medical imaging, laboratory tests, and point-of-care tests) during GP out-of-hours care in the Netherlands and to assess whether access differs between services located adjacent to or separate from an Accident and Emergency (A&E) department.

Design

Cross-sectional survey.

Method

In 2014 we invited all GP out-of-hours services in the Netherlands to participate in a survey on GPs’ access to diagnostic tests in Dutch GP out-of-hours services.

Results

117 GP out-of-hours services participated in the survey; response rate 100%. Although access to diagnostic tests during GP out-of-hours care varied across services, overall there was limited access. Electrocardiography was available in 26% (30/117) of all services, and conventional radiography in 19% (22/117). Access to various types of laboratory tests ranged between 37% (43/117) and 65% (76/117). All services had glucose point-of-care tests and urine dipstick tests available. We observed no relevant differences in access to in-house diagnostic tests between services adjacent to or separate from an A&E department. More than half (56%) of out-of-hours services expressed plans to expand their diagnostic facilities.

Conclusion

GPs in the Netherlands have limited and varying access to diagnostic tests in GP out-of-hours services. GPs working in out-of-hours services adjacent to A&E departments do not have wider access to diagnostic tests than GPs working at a separate location. With current developments towards joint organisation structures of GP out-of-hours services and A&E departments in the Netherlands, the organisation of diagnostic facilities within out-of-hours care may be subject of debate.

Conflict of interest and financial support for this article: J.W.L. Cals is supported by a Veni grant (no. 91614078) from the Netherlands Organisation for Health Research and Development (ZonMw).