After-hours information given by telephone by family physicians in Ontario

Abstract

This study describes instructions for after-hours care offered by family physicians offices when patients telephone the practice. Randomly selected (n=1,680) Ontario family physicians and general practitioners were telephoned after hours from October 2007 to February 2008. Instructions among the 1,102 eligible offices suggested emergency services (58.6%; 646/1,102), the toll-free, nurse-staffed Telephone Health Advisory Service (THAS) with on-call physician back-up (45.0%; 496/1,102), the practice's own after-hours clinic (27.9%; 307/1,102), an on-call physician (8.0%; 88/1,102) or a walk-in clinic (6.9%; 76/1,102). Some messages (13.9%; 153/1,102) provided no instructions. Physicians in a reformed model with obligations to provide some after-hours care were more likely to advise an after-hours clinic (32.0%; 285/891) than other physicians (10.4%; 22/211) (p<0.001). Many family physician telephone messages in Ontario suggest emergency services only or do not provide any instructions. Only slightly more than half suggest use of the government-funded THAS. Patients may be unaware of many after-hours care options.