Pediatr Emerg Med J.  2016 Jun;3(1):1-8. 10.0000/pemj.2016.3.1.1.

Non-emergency department models for pediatric after-hours care

Affiliations
  • 1Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. mijinkimkorea@gmail.com

Abstract

After-hours care (AHC) provides urgent primary care at nighttime, weekends, and holidays. In Korea, individual primary care physicians seldom participate in AHC and many parents have difficulty in receiving primary care during non-office hours without going to an emergency department (ED). The ED is currently the only place to access a full range of services at any time. However, the ED is not optimized for AHC, and using it for AHC is not an efficient use of resources. Therefore, many countries are seeking a safe, efficient non-ED AHC model which provides the best care considering the limitations. Different models for AHC exist worldwide, varying from family doctor-based to hospital-based models, and some countries use several different models including 24-hr telephone triage and advice services (TTA). Common problems of AHC include the inaccessibility to primary care, discontinuity of care, expensive healthcare costs, and work dissatisfaction among health care professionals. These are the major reasons for the recent changes made to the AHC system in many countries, such as the integration into one single national TTA in the United Kingdom, support for group practices in Canada, reorganization of small practice rotation groups into large scaled, general practitioner cooperatives in the Netherlands, and rapid expansion of the urgent care industry in the United States. This review presents a brief overview of the current AHC in Korea and the need for an effective non-ED AHC model. An effective AHC system will improve the quality of care, financial saving, and job satisfaction of the health care professionals.

Keyword

After-Hours Care; Ambulatory Care Facilities; Child; Delivery of Health Care; General Practitioners; Night Care; Primary Health Care

MeSH Terms

After-Hours Care*
Ambulatory Care
Ambulatory Care Facilities
Canada
Child
Delivery of Health Care
Emergency Service, Hospital
General Practitioners
Great Britain
Group Practice
Health Care Costs
Holidays
Humans
Job Satisfaction
Korea
Netherlands
Night Care
Parents
Physicians, Primary Care
Primary Health Care
Telephone
Triage
United States
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