Emergency Care Services

The organisation of out-of-hours primary care in OECD countries

“…Countries with more robust after-hours options for care, as well as those with short waiting times for a primary care appointment, seem less likely to have a high volume of ED visits. By contrast, countries where patients are unable to obtain a rapid primary care appointment or where access to OOH services outside hospital EDs is limited display a high volume of ED visits (Berchet, 2015). This tendency is confirmed by Figure 1 above.…”

“…Many patients who cannot access OOH primary care seek care in hospital EDs. "Inappropriate" or non-urgent visits are characterised by low urgency problems and require other health services than emergency admission (Berchet, 2015). Such inappropriate ED visits are for conditions that could be better managed in the community by a PCP or by the broader primary care clinical team.…”

“…Studies indicate between 12% and 56% of ED visits are to patients with non-serious problems that could be better managed in the community by a PCP. Inappropriate visits to EDs account for nearly 12% of ED visits in the United States and England, 20% in Italy and France, 25% in Canada, 31% in Portugal, 32% in Australia and 56% in Belgium (Berchet, 2015).…”

“…Primary care centres (PCCs), walk-in clinics, minor injury units (MIUs) and urgent care centres (UCCs) are very similar facilities designed to provide OOH primary care services for patients with minor injuries or illness (Berchet, 2015). Care is often provided to patients on a walk-in basis, and is often considered a substitute to home visits and non-urgent hospital ED visits.…”

Patient motives behind low-acuity visits to the emergency department in Germany: a qualitative study comparing urban and rural sites

“…Around 10 million patients visit German EDs per year (12 visits per 1000 inhabitants), 5 which is still a relatively low number compared to other OECD countries (average of 31 visits per 1000 inhabitants). 23 However, the annual growth rate of ED visits in Germany is, at about 5%, 23 24 one of the highest among OECD countries. The increasing number of ED visits has caused a debate among political decisionmakers and providers of health services in Germany about the need for policy interventions in the general public and the healthcare system.…”