Contact to the out-of-hours service among Danish parents of small children – a qualitative interview study

Abstract

Objective: In Denmark, parents with small children have the highest contact frequency to out-of-hours (OOH) service, but reasons for OOH care use are sparsely investigated. The aim was to explore parental contact pattern to OOH services and to explore parents’ experiences with managing their children’s acute health problems.

Design: A qualitative study was undertaken drawing on a phenomenological approach. We used semi-structured interviews, followed by an inductive content analysis. Nine parents with children below four years of age were recruited from a child day care centre in Aarhus, Denmark for interviews.

Results: Navigation, information, parental worry and parental development appeared to have an impact on OOH services use. The parents found it easy to navigate in the health care system, but they often used the OOH service instead of their own general practitioner (GP) due to more compatible opening hours and insecurity about the urgency of symptoms. When worried about the severity, the parents sought information from e.g. the internet or the health care professionals. The first child caused more worries and insecurity due to less experience with childhood diseases and the contact frequency seemed to decrease with parental development.

Conclusion: Parents’ use of the OOH service is affected by their health literacy levels, e.g. level of information, how easy they find access to their GP, how trustworthy and authorized health information is, as well as how much they worry and their parental experience. These findings must be considered when planning effective health services for young families.

Key points

• The main findings are that the parents in our study found it easy to navigate in the healthcare system, but they used the OOH service instead of their own general practitioner, when this suited their needs. The parents sought information from e.g. the internet or the health care professionals when they were worried about the severity of their children’s diseases. They sometimes navigated strategically in the healthcare system by e.g. using the OOH service for reassurance and when it was most convenient according to opening hours. The first child seemed to cause more worries and insecurity due to limited experience with childhood diseases, and parental development seems to decrease contact frequency.

• Overall, this study contributes with valuable insights into the understanding of parents’ help seeking behaviour. There seems to be a potential for supporting especially first-time parents in their use of the out of hours services.

Keywords:

• After hours care
• primary health care
• health literacy
• paediatrics
• parents
• medical necessity
• help-seeking

Ethics

This study was performed as a part of ML's and CRT's Master of Science in Public Health Programme, and therefore has not been reported to the Data Inspectorate. However, person-identifying information was treated confidentially and unavailable to unauthorized persons. In addition, we obtained both written and oral consent from the informants.

Disclosure statement

The authors declare that they have no competing interests.

Additional information

Notes on contributors

Marie Lass

Marie Lass has a Master in Public Health from Aarhus University, Denmark.

Camilla Rahr Tatari

Camilla Rahr Tatari has a Master in Public Health from Aarhus University, Denmark.

Camilla Hoffmann Merrild

Camilla Hoffmann Merrild is a post-doctoral researcher at the Research Unit for General Practice, Department of Public Health, Aarhus University. She has worked extensively on health care seeking, symptom experiences and social inequality in health, and is particularly interested in the interaction between health care systems and vulnerable groups.

Linda Huibers

Dr. Linda Huibers is a senior researcher at the Research Unit for General Practice, Department of Public Health, Aarhus University. Her main research areas are out-of-hours and acute primary care, including telephone triage, patient behaviour and use of out-of-hours care. She forms part of several international collaborations in this field.

Helle Terkildsen Maindal

Dr. Terkildsen Maindal is professor in Health promotion at the Department of Public Health, Aarhus University, Denmark working in health promotion, prevention and behavioral medicine in diabetes and other NCDs. She is a leading figure in international recognised interdisciplinary and cross-sectorial research, and chairs the Danish Health literacy Network.