Does setting up out of hours primary care cooperatives outside a hospital reduce demand for emergency care?

Abstract
Objective: To investigate whether the reorganisation of out of hours primary care, from practice rotas to GP cooperatives, changed utilisation of primary and hospital emergency care. Methods: During a four week period before and a four week period after the reorganisation of out of hours primary care in a region in the south of the Netherlands all patient contacts with general practitioners and hospital accident and emergency (A&E) departments were analysed. Results: A 10% increase was found in patient contacts with out of hours primary care, and a 9% decrease in patient contacts with out of hours emergency care. The number of self referrals at the A&E department was reduced by about 4%. Conclusions: The reorganisation of out of hours primary care has led to a shift in patient contacts from emergency care to primary care.