Abstract

FIRMINO-MACHADO, João; YAPHE, John; RIBAS, Maria José  and  COSTA, Patrício. The ideal site for provision of out-of-hours care in primary care: An analysis of costs and perception of quality of services. Rev Port Med Geral Fam [online]. 2017, vol.33, n.2, pp.92-104. ISSN 2182-5173.

Objective: This study aims to compare the costs of out-of-hours services and patient Perceptions of Service Quality (PSQ), between a regular primary care units and a specialized unit only opened to perform this kind of care. Type of study: Cross-sectional - analytical and observational. Local: Unidade de Saúde Familiar (USF) Serpa Pinto, USF Ramalde and Serviço de Atendimento de Situações Urgentes (SASU) do Porto, from Agrupamento de Centros de Saúde Porto Ocidental. Population: Patients who attend out-of-ours services at the enrolled health units. Methods: A questionnaire developed by the research team was used to determine PSQ. The SERVQUAL/SERVPERF instruments and their adaptations to health sector, particularly HEALTHQUAL, were used as models. The instrument was applied to 281 patients in both units. The comparison of costs between units was determined through the analysis of 820 clinical records. National reference values were used to calculate costs of drugs and laboratory tests. Results: Significantly higher values of perception of service quality were found among patients treated in the USF compared to SASU, controlling for the patient's socio-demographic characteristics. No significant differences were found in costs between units. The mean costs per patient in the USF were € 9.3 (SD=14.9) compared to € 8.2 (SD=8.2) for the SASU. Discussion/Conclusion: If high quality after hours care with greater patient satisfaction can be provided in family health units at similar costs to care in emergency units, there is no evidence in favour of closing after hours care services in family health units.

Keywords : Patient satisfaction; Primary health care; Health care costs; After-hours care.

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