We conducted a four months' pre-post comparison before and after the implementation of a co-located GPC with an urban ED in the Netherlands.
RESULTS:
More than half of our ED patients were self-referrals. At triage, 54.5% of these self-referrals were redirected to the GPC. After assessment at the GPC, 8.5% of them were referred back to the ED. The number of patients treated at the ED declined with 20.3% after the introduction of the GPC. In the remaining ED population, there was a significant increase of highly urgent patients (P<0.001), regular admissions (P<0.001), and ICU admissions (P<0.001). Despite the decline of the number of patients at the ED, the total length of stay of patients treated at the ED increased from 14682 hours in the two months' control period to 14962 hours in the two months' intervention period, a total increase of 270 hours in two months (P<0.001).
CONCLUSION:
Introduction of a GPC led to efficient redirection of self-referrals but failed to improve throughput of the remaining patients at the ED.