The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational Study
Introduction. A new model, an emergency care access point (ECAP) for after-hours emergency care, is emerging in The Netherlands. This study assessed the effect on emergency department (ED) utilization and patient flows. Methods. Routinely recorded clinical ED patient data, covering a six-year perio...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2013/364659 |
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| author | W. A. M. H. Thijssen M. Wijnen-van Houts J. Koetsenruijter P. Giesen M. Wensing |
| author_facet | W. A. M. H. Thijssen M. Wijnen-van Houts J. Koetsenruijter P. Giesen M. Wensing |
| author_sort | W. A. M. H. Thijssen |
| collection | DOAJ |
| description | Introduction. A new model, an emergency care access point (ECAP) for after-hours emergency care, is emerging in The Netherlands. This study assessed the effect on emergency department (ED) utilization and patient flows.
Methods. Routinely recorded clinical ED patient data, covering a six-year period, was collected. Segmented regression analysis was used to analyze after-hours changes over time.
Results. 59.182 patients attended the ED before the start of the ECAP and 51.513 patients after, a decrease of 13%. Self-referred ED patients decreased 99.5% (OR 0.003; 95% CI 0.002–0.004). Referred patients increased by 213.4% and ED hospital admissions increased by 20.2%. A planned outpatient follow-up increased by 5.8% (OR 1.968 95% CI 1.870–2.071). The latter changed from fewer contacts to more contacts (OR 1.015 95% CI 1.013–1.017). Consultations at the regional genereral practitioner cooperative (GPC) increased by 26.0% (183.782 versus 232.246).
Conclusion. ECAP implementation resulted in a decrease in ED utilization, a near absence of self-referring patients, and a higher probability of hospital admission and clinical follow-up. This suggests either an increase of ED patients with a higher acuity or a lower threshold of admitting referred patients compared to self-referred patients. Overall, increased collaboration with after-hours primary care and emergency care seemed to optimize ED utilization. |
| format | Article |
| id | doaj-art-dba405c9e06647fab36be2bf64a0bd01 |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-dba405c9e06647fab36be2bf64a0bd012025-02-03T01:33:11ZengWileyEmergency Medicine International2090-28402090-28592013-01-01201310.1155/2013/364659364659The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational StudyW. A. M. H. Thijssen0M. Wijnen-van Houts1J. Koetsenruijter2P. Giesen3M. Wensing4Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602ZA NB Eindhoven, The NetherlandsCatharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602ZA NB Eindhoven, The NetherlandsIQ Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, IQ P.O. Box 9101, Healthcare 114, 6500HBGLO Nijmegen, The NetherlandsIQ Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, IQ P.O. Box 9101, Healthcare 114, 6500HBGLO Nijmegen, The NetherlandsIQ Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, IQ P.O. Box 9101, Healthcare 114, 6500HBGLO Nijmegen, The NetherlandsIntroduction. A new model, an emergency care access point (ECAP) for after-hours emergency care, is emerging in The Netherlands. This study assessed the effect on emergency department (ED) utilization and patient flows. Methods. Routinely recorded clinical ED patient data, covering a six-year period, was collected. Segmented regression analysis was used to analyze after-hours changes over time. Results. 59.182 patients attended the ED before the start of the ECAP and 51.513 patients after, a decrease of 13%. Self-referred ED patients decreased 99.5% (OR 0.003; 95% CI 0.002–0.004). Referred patients increased by 213.4% and ED hospital admissions increased by 20.2%. A planned outpatient follow-up increased by 5.8% (OR 1.968 95% CI 1.870–2.071). The latter changed from fewer contacts to more contacts (OR 1.015 95% CI 1.013–1.017). Consultations at the regional genereral practitioner cooperative (GPC) increased by 26.0% (183.782 versus 232.246). Conclusion. ECAP implementation resulted in a decrease in ED utilization, a near absence of self-referring patients, and a higher probability of hospital admission and clinical follow-up. This suggests either an increase of ED patients with a higher acuity or a lower threshold of admitting referred patients compared to self-referred patients. Overall, increased collaboration with after-hours primary care and emergency care seemed to optimize ED utilization.http://dx.doi.org/10.1155/2013/364659 |
| spellingShingle | W. A. M. H. Thijssen M. Wijnen-van Houts J. Koetsenruijter P. Giesen M. Wensing The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational Study Emergency Medicine International |
| title | The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational Study |
| title_full | The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational Study |
| title_fullStr | The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational Study |
| title_full_unstemmed | The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational Study |
| title_short | The Impact on Emergency Department Utilization and Patient Flows after Integrating with a General Practitioner Cooperative: An Observational Study |
| title_sort | impact on emergency department utilization and patient flows after integrating with a general practitioner cooperative an observational study |
| url | http://dx.doi.org/10.1155/2013/364659 |
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