Non-urgent patients in the Emergency Departement

Abstract

The non-urgent patients in the Emergency Departement (ED) are a widespread challenging problem. In the present study we investigated the relationship between the non-urgent patients in ED and the primary care services in an urban area (Mestre- Venezia). An alternative management of these patients supported by a group of family doctors in a separate laboratory, close to the ED, and using the ED triage system, has also been studied. The management of these patients in terms of waiting time, percent of patients who have left the ED without being seen and inappropriate dismissions, was sactisfactory. Otherwise 50% of the patients were sent to an urgent specialistic advisory in spite of their non-urgent problem presented. The involvement of primary care providers and a reasonable limit to an unjustified specialistic advisory are requiered to achieve a reliable alternative management for non-urgent patients in ED

Prevalence, determinants and practical implications of inappropriate hospitalizations in older subjects: A prospective observational study

“…Indeed, the clinical implications in terms of hospital overcrowding are critically dependent on the local organization of healthcare; that is, whether or not an immediate and direct transfer from the ED to other appropriate care settings is available. A wide implementation of these care pathways seems to be essential to reduce the burden of unnecessary hospitalization [48]. Moreover, our study might have overestimated the rate of inappropriate hospitalizations because of daytime recruitment of patients, since it is reasonable to assume a higher proportion of patients appropriately accessing the ED, and thus later being appropriately hospitalized, at night and during weekends.…”