Verminderen van zorgconsumptie op huisartsenposten

Keizer, Ellen; Maassen, Irene; Smits, Marleen; Giesen, Paul

doi:10.1007/s12445-014-0263-y

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…Additionally, we have poor understanding of the initial presentation of patients with chest pain in out-of-hours primary care, as prior research has exclusively focused on either office hours primary care or emergency departments (McConaghy and Oza, 2013;Frese et al, 2016;Hoorweg et al, 2017). As a result, the diagnostic value of the NTS in out-of-hours primary care has been largely criticized by PCPs as well as ambulance services (Keizer et al, 2014). Triage inefficiency has been named as a main factor leading to frequent consultations for non-urgent cases and a high rate of unnecessary ambulance deployments, but other factors also play(ed) a role (i.e., organizational and cultural changes, financial and legal incentives) (Keizer et al, 2014;Smits and Verheij, 2017).…”

Section: Background and Rationalementioning

confidence: 99%

“…As a result, the diagnostic value of the NTS in out-of-hours primary care has been largely criticized by PCPs as well as ambulance services (Keizer et al, 2014). Triage inefficiency has been named as a main factor leading to frequent consultations for non-urgent cases and a high rate of unnecessary ambulance deployments, but other factors also play(ed) a role (i.e., organizational and cultural changes, financial and legal incentives) (Keizer et al, 2014;Smits and Verheij, 2017). Additionally, prior research has concluded that the urgency is underestimated in 19% of cases, potentially leading to unsafe situations (Giesen et al, 2007;Keizer et al, 2014;Ambulancezorg Nederland, 2017;Smits and Verheij, 2017;Zeilstra and Giesen, 2017).…”

Section: Background and Rationalementioning

confidence: 99%

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Rationale and design of a cohort study evaluating triage of acute chest pain in out-of-hours primary care in the Netherlands (TRACE)

Manten

Cuijpers

Rietveld

et al. 2020

Prim Health Care Res Dev

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The aims of this study are (1) to evaluate the performance of current triage for chest pain; (2) to describe the case mix of patients undergoing triage for chest pain; and (3) to identify opportunities to improve performance of current Dutch triage system for chest pain. Chest pain is a common symptom, and identifying patients with chest pain that require urgent care can be quite challenging. Making the correct assessment is even harder during telephone triage. Temporal trends show that the referral threshold has lowered over time, resulting in overcrowding of first responders and emergency services. While various stakeholders advocate for a more efficient triage system, careful evaluation of the performance of the current triage in primary care is lacking. TRiage of Acute Chest pain Evaluation in primary care (TRACE) is a large cohort study designed to describe the current Dutch triage system for chest pain and subsequently evaluate triage performance in regard to clinical outcomes. The study consists of consecutive patients who contacted the out-of-hours primary care facility with chest pain in the region of Alkmaar, the Netherlands, in 2017, with follow-up for clinical outcomes out to August 2019. The primary outcome of interest is ‘major event’, which is defined as the occurrence of death from any cause, acute coronary syndrome, urgent coronary revascularization, or other high-risk diagnoses in which delay is inadmissible and hospitalization is necessary. We will evaluate the performance of the triage system by assessing the ability of the triage system to correctly classify patients regarding urgency (accuracy), the proportion of safe actions following triage (safety) as well as rightfully deployed ambulances (efficacy). TRACE is designed to describe the current Dutch triage system for chest pain in primary care and to subsequently evaluate triage performance in regard to clinical outcomes.

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