Patients either contacting a general practice cooperative or accident and emergency department out of hours: a comparison.
until further notice
SourceEmergency Medicine Journal, 23, 9, (2006), pp. 731-734
Article / Letter to editor
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OUD - Nijmeegs Instituut voor Missiewetenschappen (NIM)
Centre for Quality of Care Research
Emergency Medicine Journal
SubjectEBP 3: Effective Primary Care and Public Health; EBP 4: Quality of Care; N4i 1: Pathogenesis and modulation of inflammation; NCEBP 3: Implementation Science; NCEBP 4: Quality of hospital and integrated care; NCEBP 7: Effective primary care and public health; UMCN 4.3: Tissue engineering and reconstructive surgery
INTRODUCTION: Lack of collaboration between general practice (GP) cooperatives and accident and emergency (A&E) departments and many self referrals may lead to inefficient out-of-hours care. METHODS: We retrospectively analysed the records of all patients contacting the GP cooperative and all patients self referring to the A&E department out of hours in a region in the Netherlands. Results : 258 patients contacted the GP cooperative and 43 self referred to the A&E department per 1000 patients per year. A wide range of problems were seen in the GP cooperative, mainly related to infections (26.2%). The A&E department had a smaller range of problems, mainly related to trauma (66.1%). Relatively few urgent problems were seen in the GP cooperative (4.6%) or for self referrals in the A&E department (6.1%). Women, children, the elderly, and rural patients chose the GP cooperative significantly more often, as did men and patients with less urgent complaints, infections, and heart and airway problems. DISCUSSION: The contact frequency of self referrals to the A&E department is much lower than that at the GP cooperative. Care is complementary: the A&E department focuses on trauma while the GP cooperative deals with a wide range of problems. The self referrals concern mostly minor, non-urgent problems and can generally be treated by the general practitioner, by a nurse, or by advice over the telephone, particularly in the case of optimal collaboration in an integrated care facility of GP cooperatives and A&E departments with one access point to medical care for all patients.
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