ED patients: how nonurgent are they? Systematic review of the emergency medicine literature

Durand, Anne; Gentile, Stéphanie; Devictor, Bénédicte; Palazzolo, Sylvie; Vignally, Pascal; Gerbeaux, Patrick; Sambuc, Roland

doi:10.1016/j.ajem.2010.01.003

Cited by 213 publications

(235 citation statements)

References 51 publications

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“…In the USA, the estimated rates are lower, ranging from between 5% and 13% (McCraig et al, 2006;GAO, 2009). Figures vary depending not only on the institutional circumstances, but also on the alternative criteria used to identify patients that could be treated in a primary care setting (Durand et al, 2011). One frequently-held view is that ED attenders requiring urgent treatment are considered appropriate users of the hospital, whilst non-urgent cases are classified as inappropriate.…”

Section: Introductionmentioning

confidence: 99%

Does the extension of primary care practice opening hours reduce the use of emergency services?

Bruni

Mammi

Ugolini

2016

Journal of Health Economics

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Over-crowding in Emergency Departments (EDs) generates potential inefficiencies. Using regional administrative data, we investigate the impact of an increase in the accessibility of primary care on ED visits in Italy. We test whether extending practice opening hours up to 12 hours/day reduces inappropriate ED visits. We estimate count data models, considering different measures for ED visits recorded at the list level.Since the extension programme is voluntary, we also account for the potential endogeneity of participation, using a two-stage residual inclusion and a GMM approach. Our results show that improving primary care accessibility favours a more appropriate use of EDs.

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Section: Introductionmentioning

confidence: 99%

Does the extension of primary care practice opening hours reduce the use of emergency services?

Bruni

Mammi

Ugolini

2016

Journal of Health Economics

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“…Likewise, at the emergency department (ED) there is also a great demand for care of patients with non-urgent problems. [4] Contacts of patients with unnecessary problems lead to inefficient use of resources. [5][6][7] In the Netherlands, the total cost of evening duties, night duties as well as weekend duties have increased in the period between 2010 and 2014 by more than 62 million euros (26%).…”

Section: Introductionmentioning

confidence: 99%

Reducing the use of out-of-hours primary care services: A survey among Dutch general practitioners

Keizer¹,

Maassen²,

Smits³

et al. 2016

European Journal of General Practice

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KEY MESSAGESGPs believe that the number of patient contacts with the GP cooperative could be reduced. Strategies to reduce the use of GP cooperatives perceived as both effective and advisable by GPs are introducing co-payment for patients, stricter triage and a larger role for the telephone consultation doctor. ABSTRACTBackground: Out-of-hours primary care services have a high general practitioner (GP) workload with increasing costs, while half of all contacts are non-urgent. Objectives: To identify views of GPs to influence the use of the out-of-hours GP cooperatives. Methods: Cross-sectional survey study among a random sample of 800 GPs in the Netherlands. Results: Of the 428 respondents (53.5% response rate), 86.5% confirmed an increase in their workload and 91.8% felt that the number of patient contacts could be reduced. A total of 75.4% GP respondents reported that the 24-h service society was a 'very important' reason why patients with non-urgent problems attended the GP cooperative; the equivalent for worry or anxiety was 65.8%, and for easy accessibility, 60.1%. Many GPs (83.9%) believed that the way telephone triage is currently performed contributes to the high use of GP cooperatives. Measures that GPs believed were both desirable and effective in reducing the use of GP cooperatives included copayment for patients, stricter triage, and a larger role for the telephone consultation doctor. GPs considered patient education, improved telephone accessibility of daytime general practices, more possibilities for same-day appointments, as well as feedback concerning the use of GP cooperatives to practices and triage nurses also desirable, but less effective. Conclusion: This study provides several clues for influencing the use of GP cooperatives. Further research is needed to examine the impact and safety of these strategies.

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“…Il n'existe pas de définition universel des 'patients non urgents' [21,22]. la littérature a décrit une très grande variabilité dans la proportion des patients non urgents (4.8 à 90%) ; un manque de reliabilité et de reproductibilité des méthodes et les critères de catégorisation des patients aux urgences [23]. les patients considérés comme non urgents restent mal identifiés et plusieurs facteurs sont intégrés dans leur catégorisation aussi bien médicaux, sociaux que environnementaux.…”

Section: Concept D'urgence : Genese Et Evolution Dans Le Tempsunclassified

Emergencies and Disaster Medicine

Belayachi

Abouqal

2017

IJMS

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ED patients: how nonurgent are they? Systematic review of the emergency medicine literature

Cited by 213 publications

References 51 publications

Does the extension of primary care practice opening hours reduce the use of emergency services?

Does the extension of primary care practice opening hours reduce the use of emergency services?

Reducing the use of out-of-hours primary care services: A survey among Dutch general practitioners

Emergencies and Disaster Medicine

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