Primary care in London: an evaluation of general practitioners working in an inner city accident and emergency department.

Ward, Patricia; Huddy, J; Hargreaves, Sally; Touquet, Robin; Hurley, J.; Fothergill, J

doi:10.1136/emj.13.1.11

Cited by 41 publications

(67 citation statements)

References 8 publications

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“…It also seems to be cost-effective. 7,8 A possible disadvantage of this innovation is that GPs who work directly within an ED may adjust their own medical practice to fit in with common ED practices. Westert 9 showed that specialists choose different lengths of stay when working in different hospitals, thereby demonstrating that setting affects behavior.…”

Section: Innovationsmentioning

confidence: 99%

Out-of-Hours Care Collaboration between General Practitioners and Hospital Emergency Departments in the Netherlands

Rooij

Yzermans

Broekman

et al. 2015

The Journal of the American Board of Family Medicine

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Objective: In the Netherlands, general practitioners (GPs) and emergency departments (EDs) collaborate increasingly in what is called an Urgent Care Collaboration (UCC). In UCCs, GPs and EDs share 1 combined entrance and joint triage. The objective of this study was to determine if GPs treat a larger proportion of out-of-hours patients in the UCC system, and how this relates to patient characteristics.Methods: This observational study compared patients treated within UCCs with patients treated in the usual care setting, that is, GPs and EDs operating separately. Data on the characteristics of the patients, their consultations, and their health problems were derived from electronic medical records. We performed 2 tests, independent sample t tests, and multiple logistic regression analyses. Results: A significantly higher proportion of patients attended their on-call GP within the UCC system. The proportion of ED patients was 22% smaller in UCCs compared to the usual care setting. Controlled for patient and health problem characteristics the difference remained statistically significant (OR‫;96.0؍‬ CI 0.66 -0.72) but there were substantial differences between regions. Especially patients with trauma were treated more by general practitioners. Controlled for case mix, patients in the largest UCC-region were 1.2 times more likely to attend a GP than the reference group.

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Section: Innovationsmentioning

confidence: 99%

Out-of-Hours Care Collaboration between General Practitioners and Hospital Emergency Departments in the Netherlands

Rooij

Yzermans

Broekman

et al. 2015

The Journal of the American Board of Family Medicine

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“…United Kingdom studies confirm that GP hospitals save costs by reducing referrals and admissions to higher-cost general hospitals staffed by specialists (57,58,59). Care delivered by general practitioners, compared to hospital specialists, in hospital-based accident and emergency departments was shown to be more cost effective with lower use of diagnostic investigations, lower referral rates to secondary services, lower prescription levels, and no significant difference in patient satisfaction or health outcomes (60,61,62).…”

Section: Cost Effectivenessmentioning

confidence: 80%

The Effect of Rostering with a Patient Enrolment Model on Emergency Department Utilization

Tiagi

Chechulin

2014

hcpol

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This is a Health Evidence Network (HEN) synthesis report on the advantages and disadvantages of restructuring a health care system to be more focused on primary care services.The available evidence demonstrates some advantages for health systems that rely relatively more on primary health care and general practice in comparison with systems more based on specialist care in terms of better population health outcomes, improved equity, access and continuity and lower cost.This report is HEN's response to a question from a decision-maker. It provides a synthesis of the best available evidence, including a summary of the main findings and policy options related to the issue.HEN, initiated and coordinated by the WHO Regional Office for Europe, is an information service for public health and health care decision-makers in the WHO European Region. Other interested parties might also benefit from HEN.This HEN evidence report is a commissioned work and the contents are the responsibility of the authors. They do not necessarily reflect the official policies of WHO/Europe. The reports were subjected to international review, managed by the HEN team.When referencing this report, please use the following attribution:

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“…Most of the included citations were variations on an uncontrolled before and after study, with one quasi-randomised evaluation,10 two randomised controlled trials (RCTs)11 12 and one pragmatic prospective evaluation 13…”

Section: Resultsmentioning

confidence: 99%

“…Six studies10 12 13 18 19 21 reported more diagnostic testing (predominantly radiography and blood tests) by ED clinicians than GPs in the ED or adjacent service. One study using GPs within the ED11 found no difference in the use of investigations (RR 1.06; 95% CI 1.00 to 1.13) between ED and GP clinicians.…”

Section: Resultsmentioning

confidence: 99%

Primary care services located with EDs: a review of effectiveness

Ramlakhan¹,

Mason

O’Keeffe

et al. 2016

Emerg Med J

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Primary care in London: an evaluation of general practitioners working in an inner city accident and emergency department.

Cited by 41 publications

References 8 publications

Out-of-Hours Care Collaboration between General Practitioners and Hospital Emergency Departments in the Netherlands

Out-of-Hours Care Collaboration between General Practitioners and Hospital Emergency Departments in the Netherlands

The Effect of Rostering with a Patient Enrolment Model on Emergency Department Utilization

Primary care services located with EDs: a review of effectiveness

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