Patient house calls in Attica and Thessaloniki, Greece (2005-2015): a model for out-of-hospital multispecialty emergency medicine.

BACKGROUND: The SOS-doctors are a network of physicians who perform house-call visits in the areas of Attica and Thessaloniki, Greece. METHODS: Patients requesting medical services by the SOS doctors during the period 1/1/2005 - 31/12/2015 were eligible for inclusion in this retrospective analysis. RESULTS: During this period 335, 212 home visits were performed. Females used this service more frequently compared to males (60.5% versus 39.5%). Among the age-groups, patients aged over 75 years made 56.6% of all house calls. Fewer phone requests were recorded during autumn than in winter (21.1% versus 29.1%). Infections were the most common cause of house-visits (29%), followed by cardiovascular diseases (10.3%), musculoskeletal (9.1%), gastrointestinal (6.3%) and neurological disorders (3.7%). An increasing demand for radiology at home was observed, starting at 352 calls in 2009 and reaching 2230 in 2015. Finally, 9.2% of patients were advised to be admitted into a hospital. CONCLUSION: A shift towards older age, but not the oldest old (> 90 years), and acute conditions was observed during the study period. The study confirms that home visits retain a significant role in the modern health care systems.

Evaluation of a direct test for seasonal influenza in outpatients.

OBJECTIVE: To present our experience regarding the use of a rapid diagnostic test for seasonal influenza A and B. METHODS: We systematically collected and analyzed our data regarding the use of a rapid diagnostic test for seasonal influenza A and B in patients with specific respiratory symptoms that sought medical services, during the time period from 01/01/2009 to 30/05/2009, from a network of physicians (SOS Doctors) who perform house-call visits in the area of Attica, Greece. RESULTS: From the total of 16,335 house-call visits performed during the evaluated period, 3412 (20.8%) were due to respiratory/influenza symptoms; 197 (5.8%) patients were tested for influenza. From the 184 patients with available data regarding the test result, 97 (52.7%) were positive for influenza. Significantly more oseltamivir and less antibiotic treatment were prescribed to patients with positive test result compared with those with a negative test result. Additionally, the impact of the test in the participating physicians' decision making was obvious, as doctors who used the test systematically prescribed significantly more oseltamivir and less antibiotic treatment compared to the doctors who didn't use the test. CONCLUSION: The use of a rapid test for seasonal influenza enabled the targeted treatment with oseltamivir, as well as a reduction in antibiotic treatment, in patients found positive for influenza in our clinical setting.