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After-hours primary care for people with intellectualdisabilities in The Netherlands—Current arrangements andchallenges.

Heutmekers, M., Naaldenberg, J., Frankena, T.K., Smits, M., Leusink, G.L., Assendelft, W.J.J., Schrojenstein Lantman-de Valk, H.M.J. van. After-hours primary care for people with intellectualdisabilities in The Netherlands—Current arrangements andchallenges. Research in Developmental Disabilities: 2016, 59(1), p. 1-7.
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Background
Little is known about the organisation of after-hours primary care for peoplewith intellectual disabilities (ID), and mainstream care is not self-evidently accessible orfit for this group. A first step towards improvement is a greater understanding of currentafter-hours primary ID care.

Aims
This study explores the organisation of and experiences with after-hours primarycare provided for people with ID in The Netherlands.

Methods and procedures
A telephone survey amongst 68 care provider services includingquestions on organisational characteristics, problem areas, facilitators, and inhibitors.

Outcomes and results
A multitude of different after-hours primary care arrangements werefound. Primary care physicians (PCPs) were involved in almost all care provider services,often in alliance with PCP cooperatives. Specialised ID physicians had differing roles asgatekeeper, primary caregiver, or consultant. Most problems during the after-hours aroseregarding daily care professionals’ competences. Facilitators and inhibitors of after-hoursprimary care were themed around complexity of, and need for, specialised care, multi-disciplinary team of professionals, communication and information, and prerequisites atorganisational level.

Conclusions and implications
Evidence on specific after-hours health needs of people with IDis needed to strengthen collaboration between specialist ID care services and mainstreamhealthcare services to adequately provide care.