Diverting less urgent utilizers of emergency medical services to primary care: is it feasible? Patient and morbidity characteristics from a cross-sectional multicenter study of self-referring respiratory emergency department consulters.
Felix HolzingerSarah OslisloRebecca Resendiz CantuMartin MöckelChristoph HeintzePublished in: BMC research notes (2021)
Of n = 292 self-referred patients, n = 99 were transported by EMS. Compared to non-EMS patients, these were older, triaged more urgently and arrived out-of-hours more frequently. The share of chronically and severely ill patients was greater. Out-of-hours ED visit, presence of a chronic pulmonary condition as well as a hospital diagnosis of respiratory failure were identified as determinants of EMS utilization in a logistic model, while consultation for access and quality motives as well as migrant status decreased the probability. EMS-transported lower urgency outpatients visiting during regular physicians' hours were defined as potential PC cases and evaluated descriptively (n = 9). As a third was medically complex and potentially less suitable for PC, redirection potential could be estimated at only 6% of EMS cases. This would be reduced to 2% if considering patients' judgment concerning the appropriate setting. Overall, the scope for PC diversion of respiratory EMS patients seems limited.
Keyphrases
- end stage renal disease
- primary care
- emergency department
- newly diagnosed
- chronic kidney disease
- ejection fraction
- prognostic factors
- healthcare
- peritoneal dialysis
- palliative care
- mental health
- risk assessment
- pulmonary hypertension
- respiratory failure
- patient reported outcomes
- extracorporeal membrane oxygenation
- case report
- minimally invasive
- robot assisted