Comment on 'Ambulance dispatch versus GP home visit for highly urgent out-of-hours primary care' by Plat et al.

Dear Sir,
In an interesting article, Plat et al. showed that the efficiency of out-of-hours primary care for patients with life-threatening conditions can be improved with the aim of reducing the work load for both the ambulance service and general practices cooperatives (GPCs). The authors found a large amount of overtriage and suboptimal distribution of care in patients with highly urgent complaints contacting a GPC.
The topic of research is extremely relevant as Dutch GPs have noticed an increase in patients triaged with higher urgency levels between 2012 and 2016. This increase is suspected to be due to a change in the Dutch Triage System, making it more defensive in its approach.
However, after reading the article, several questions regarding the study remain unanswered. [...]