Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands – Analyzing organization, payment and reforms

Baier, Natalie; Geißler, Alexander; Bech, Mickael; Bernstein, David N.; Cowling, Thomas E; Jackson, Terri; Manen, Johan van; Rudkjøbing, Andreas; Quentin, Wilm

doi:10.1016/j.healthpol.2018.11.001

Cited by 70 publications

(43 citation statements)

References 33 publications

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“…Australia and New Zealand have two of the best performing healthcare systems in the world. Universal healthcare is an established norm, and the vast majority of citizens have access to timely and effective emergency care (EC) …”

mentioning

confidence: 99%

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

Mitchell

Phillips

O’Reilly

et al. 2019

Emerg Medicine Australasia

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confidence: 99%

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

Mitchell

Phillips

O’Reilly

et al. 2019

Emerg Medicine Australasia

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“…Across Europe, different models of out-of-hours primary care exist6 7 and ED use must be considered among other unscheduled care options. Unscheduled care in France includes EDs but also general practitioners (GPs) performing home visits during the day time and out-of-hours or GPs with extended opening hours 8. In 2004, the French Head Office of Research, Studies, Evaluation and Statistics of the Social Affairs Ministry estimated that GPs performing home visits accounted for 5% of unscheduled care, and GPs with extended opening hours represented 11% of unscheduled care 9.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with inappropriate use of emergency departments: findings from a cross-sectional national study in France

et al. 2019

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BackgroundInappropriate visits to emergency departments (EDs) could represent from 20% to 40% of all visits. Inappropriate use is a burden on healthcare costs and increases the risk of ED overcrowding. The aim of this study was to explore socioeconomic and geographical determinants of inappropriate ED use in France.MethodThe French Emergency Survey was a nationwide cross-sectional survey conducted on June 11 2013, simultaneously in all EDs in France and covered characteristics of patients, EDs and counties. The survey included 48 711 patient questionnaires and 734 ED questionnaires. We focused on adult patients (≥15 years old). The appropriateness of the ED visit was assessed by three measures: caring physician appreciation of appropriateness (numeric scale), caring physician appreciation of whether or not the patient could have been managed by a general practitioner and ED resource utilisation. Descriptive statistics and multilevel logistic regression were used to examine determinants of inappropriate ED use, estimating adjusted ORs and 95% CIs.ResultsAmong the 29 407 patients in our sample, depending on the measuring method, 13.5% to 27.4% ED visits were considered inappropriate. Regardless of the measure method used, likelihood of inappropriate use decreased with older age and distance from home to the ED >10 km. Not having a private supplementary health insurance, having universal supplementary health coverage and symptoms being several days old increased the likelihood of inappropriate use. Likelihood of inappropriate use was not associated with county medical density.ConclusionInappropriate ED use appeared associated with socioeconomic vulnerability (such as not having supplementary health coverage or having universal coverage) but not with geographical characteristics. It makes us question the appropriateness of the concept of inappropriate ED use as it does not consider the distress experienced by the patient, and segments of society seem to have few other choices to access healthcare than the ED.

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“…Unplanned admissions take a heavy toll on healthcare systems and remain a major challenge from a cost perspective 1 2. As demand for healthcare increases worldwide, healthcare systems, including in Denmark, are being restructured and reformed to accommodate this demand and to provide continuous high-quality acute-care services 3–6…”

Section: Introductionmentioning

confidence: 99%

Increasing emergency hospital activity in Denmark, 2005–2016: a nationwide descriptive study

et al. 2020

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ObjectivesTo describe changes in unplanned acute activity and to identify and characterise unplanned contacts in hospitals in Denmark from 2005 to 2016, including following healthcare reform.DesignDescriptive study.SettingData from Danish nationwide registers.PopulationAdults (≥18 years).ParticipantsAll adults with an unplanned acute hospital contacts (acute inpatient admissions and emergency care visits) in Denmark from 2005 to 2016.Primary and secondary outcome measuresOutcomes were annual number of contacts, length of stay, number of contacts per 1000 citizen per year, age-adjusted contacts per 1000 citizens per year, sex, age groups, country of origin, Charlson Comorbidity Index score, discharge diagnosis and time of arrival.ResultsWe included a total of 13 524 680 contacts. The annual number of acute hospital contacts increased from 1 067 390 in 2005 to 1 221 601 in 2016. The number also increased with adjustment for age per 1000 citizens. In addition, regional differences were observed.ConclusionsUnplanned acute activity changed from 2005 to 2016. The national number of contacts increased, primarily because of changes in one of the five regions.

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Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands – Analyzing organization, payment and reforms

Cited by 70 publications

References 33 publications

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

Factors associated with inappropriate use of emergency departments: findings from a cross-sectional national study in France

Increasing emergency hospital activity in Denmark, 2005–2016: a nationwide descriptive study

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