□ Background: In the Wesel district (North Rhine-Westphalia), emergency ambulances have been called out with increasing frequency and hospitals report that their emergency departments (ED) are more and more being used outside consultation hours of panel doctors. Therefore, the district health conference put this issue on its agenda. □ Purpose: The aim was to obtain data on the following questions: • What do people do when they need medical help outside consultation hours of panel doctors? • Do people know that there is an on-call duty by panel doctors? Do they know how to contact this service? Do people know the Emergency Medical Service and phone number 112 and the new phone number 19222 for Patient Transport Ambulances? □ Material and Methods: The study population was defined as comprising all residents in the district of Wesel between 18 and 87 years of age (approximately 385,000 people). The sample contained 1,089 persons drawn in accordance with the Gabler-Häder method and in a second step the "birthday method" was used. The survey was carried out by the CATI Laboratory (Computer-Assisted Telephone Interviews) at the Institute of Public Health (lögd, Bielefeld, Germany) between February 18 and March 28, 2002. □ Results: (1) Being asked: "How would you act in case of a non-life-threatening disease outside consultation hours of panel doctors?", 52.6% of the respondents gave at least one correct answer; 48.6 % of all given answers were "correct" (i.e., on-call duty of Statutory Health Insurance [SHI]-accredited physicians), the others were "incorrect", i.e., "I go to the hospital/emergency department" (24.3%) or "I call the phone number 112" (13%). (2) About 80% of respondents said they heard about the on-call duty of SHI physicians. (3) 95.6% of respondents stated they knew the emergency call of the fire department; 86% of these participants were able to name the correct phone number 112. (4) About 4% of the respondents said they knew the nationwide telephone number for patient transports, and 58% of these respondents mentioned the correct number 19222. □ Conclusion: A) The tiered medical emergency system should be used adequately; this aim could be attained by (1) information of the public about the "24-h" on-call service of panel doctors; information about the fact that the majority of medical conditions can be treated by panel doctors and that in severe cases a professional and quick referral will be done; information about the fact that self-referral to hospitals may reduce or even obstruct professional resources for the treatment of "real" emergency patients. Target groups are men, younger age groups and people with a higher level of education. (2) information of target groups (elderly people) about the emergency call number 112. (3) information of the public about the national phone number 19222 for patient transports. B) Structural measures such as (1) specific on-call services, (2) improvement of the transparency and reachability of panel doctors' on-call services.
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