Implementation of a hospital-integrated general practice : a successful way to reduce the burden of inappropriate emergency-department use

Chmiel, Corinne; Wang, Mathyas; Sidler, Patrick; Eichler, Klaus; Rosemann, Thomas; Senn, Oliver

doi:10.21256/zhaw-3137

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-3137

Full metadata record

DC Field	Value	Language
dc.contributor.author	Chmiel, Corinne	-
dc.contributor.author	Wang, Mathyas	-
dc.contributor.author	Sidler, Patrick	-
dc.contributor.author	Eichler, Klaus	-
dc.contributor.author	Rosemann, Thomas	-
dc.contributor.author	Senn, Oliver	-
dc.date.accessioned	2019-07-25T13:48:48Z	-
dc.date.available	2019-07-25T13:48:48Z	-
dc.date.issued	2016-03-10	-
dc.identifier.issn	1424-7860	de_CH
dc.identifier.issn	1424-3997	de_CH
dc.identifier.uri	https://digitalcollection.zhaw.ch/handle/11475/17751	-
dc.description.abstract	Principles: Emergency departments (Eds) are over-crowded by lower acuity patients, which might be more efficiently treated by general practitioners (Gps). This study evaluated the impact of triaging lower acuity patients to a new hospital-integrated general practice (HGP) on ED case-load and the reasons for choosing the ED/HGP. Methods and Results: Patients were consecutively assessed according to the emergency severity index (ESI) to triage lower acuity patients to the HGP. Consultation numbers at the emergency centre (Ed and HGP) increased by 43% between 2007 (n=16974) and 2011 (n=24331) (implementation of HGP in 2009). Although self-referrals increased significantly at the emergency centre from 54% to 63% (p<0.001), the proportion of self-referrals at the ED was significantly reduced to 48% (p=0.007). The HGP was able to reduce the burden of increasing total consultations by 36%; 4.6% were referred back to the ED after triaging to the HGP. Overall, 95% of HGP patients were self-referred, Swiss nationals (65%) and with a personal GP (82%) they attended regularly (69%). The most common reason for presenting at the emergency centre was not being able to reach the GP(60%). Diagnoses were injury- (29%) and infection- (23%) related problems affecting the musculoskeletal (27%) system and skin (21%). Conclusion: The HGP succeeded in reducing the burden of inappropriate ED use: the majority of low acuity self-referred patients were conclusively treated at the HGP. The HGP does not represent competition to the GP out-of-hours care service, since the main reason for presenting at the hospital was not lacking a relationship but the Gps’in-accessibility.	de_CH
dc.language.iso	en	de_CH
dc.publisher	EMH Schweizerischer Ärzteverlag	de_CH
dc.relation.ispartof	Swiss Medical Weekly	de_CH
dc.rights	http://creativecommons.org/licenses/by-nc/4.0/	de_CH
dc.subject	Access to care	de_CH
dc.subject	Care management	de_CH
dc.subject	Emergency medicine	de_CH
dc.subject	Resource allocation	de_CH
dc.subject	Primary care	de_CH
dc.subject.ddc	362.11: Krankenhäuser und verwandte Einrichtungen	de_CH
dc.title	Implementation of a hospital-integrated general practice : a successful way to reduce the burden of inappropriate emergency-department use	de_CH
dc.type	Beitrag in wissenschaftlicher Zeitschrift	de_CH
dcterms.type	Text	de_CH
zhaw.departement	School of Management and Law	de_CH
zhaw.organisationalunit	Winterthurer Institut für Gesundheitsökonomie (WIG)	de_CH
dc.identifier.doi	10.21256/zhaw-3137	-
dc.identifier.doi	10.4414/smw.2016.14284	de_CH
zhaw.funding.eu	No	de_CH
zhaw.issue	w14284	de_CH
zhaw.originated.zhaw	Yes	de_CH
zhaw.pages.end	9	de_CH
zhaw.pages.start	1	de_CH
zhaw.publication.status	publishedVersion	de_CH
zhaw.volume	146	de_CH
zhaw.publication.review	Peer review (Publikation)	de_CH
zhaw.author.additional	No	de_CH
Appears in collections:	Publikationen School of Management and Law

Files in This Item:

File	Description	Size	Format
smw_2016_14284.pdf		657.33 kB	Adobe PDF	View/Open

Show simple item record

Chmiel, C., Wang, M., Sidler, P., Eichler, K., Rosemann, T., & Senn, O. (2016). Implementation of a hospital-integrated general practice : a successful way to reduce the burden of inappropriate emergency-department use. Swiss Medical Weekly, 146(w14284), 1–9. https://doi.org/10.21256/zhaw-3137

Chmiel, C. et al. (2016) ‘Implementation of a hospital-integrated general practice : a successful way to reduce the burden of inappropriate emergency-department use’, Swiss Medical Weekly, 146(w14284), pp. 1–9. Available at: https://doi.org/10.21256/zhaw-3137.

C. Chmiel, M. Wang, P. Sidler, K. Eichler, T. Rosemann, and O. Senn, “Implementation of a hospital-integrated general practice : a successful way to reduce the burden of inappropriate emergency-department use,” Swiss Medical Weekly, vol. 146, no. w14284, pp. 1–9, Mar. 2016, doi: 10.21256/zhaw-3137.

CHMIEL, Corinne, Mathyas WANG, Patrick SIDLER, Klaus EICHLER, Thomas ROSEMANN und Oliver SENN, 2016. Implementation of a hospital-integrated general practice : a successful way to reduce the burden of inappropriate emergency-department use. Swiss Medical Weekly. 10 März 2016. Bd. 146, Nr. w14284, S. 1–9. DOI 10.21256/zhaw-3137

Chmiel, Corinne, Mathyas Wang, Patrick Sidler, Klaus Eichler, Thomas Rosemann, and Oliver Senn. 2016. “Implementation of a Hospital-Integrated General Practice : A Successful Way to Reduce the Burden of Inappropriate Emergency-Department Use.” Swiss Medical Weekly 146 (w14284): 1–9. https://doi.org/10.21256/zhaw-3137.

Chmiel, Corinne, et al. “Implementation of a Hospital-Integrated General Practice : A Successful Way to Reduce the Burden of Inappropriate Emergency-Department Use.” Swiss Medical Weekly, vol. 146, no. w14284, Mar. 2016, pp. 1–9, https://doi.org/10.21256/zhaw-3137.