The effect on the patient flow in local health care services after closing a suburban primary care emergency department: a controlled longitudinal follow-up study

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dc.contributor.author Mustonen, Katri
dc.contributor.author Kantonen, Jarmo
dc.contributor.author Kauppila, Timo
dc.date.accessioned 2017-12-03T04:24:35Z
dc.date.available 2017-12-03T04:24:35Z
dc.date.issued 2017-11-28
dc.identifier.citation Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2017 Nov 28;25(1):116
dc.identifier.uri http://hdl.handle.net/10138/229029
dc.description.abstract Abstract Background It has not been studied what happens to patient flow to EDs and other parts of local health care system if distances to ED services are manipulated as a part of health policy in urban areas. Methods The present work was an observational and quasi-experimental study with a control and it was based on before-after comparisons. The impact of terminating a geographically distant suburban primary care ED on patient flow to doctors in local public primary care EDs, office-hour primary care, secondary care EDs and in private primary care was studied. The effect of this intervention was compared with a primary care system where no similar intervention was performed. The number of monthly visits to doctors in different departments of health care was scored as the main measure of the study in each department studied (e.g. in primary care EDs, secondary care ED, office-hour public primary care and private primary care). Monthly mortality rates were also recorded. Results Increasing the distance to ED services by terminating a peripheral ED did not cause an increase in the use of local office-hour services in those areas whose local ED was terminated, although use of ED services decreased by 25% in these areas (P < 0.001). The total use of primary care doctor services rather decreased - if anything - after this intervention while use of doctor services in secondary care ED remained unaffected. Doctor visits to the complementary private primary care increased but this was probably not associated with the intervention because a simultaneous increase in this parameter was observed in the control. There was no increased mortality in any age groups. Conclusion Manipulating distances to ED services can be used to direct patient flows to different parts of the health care system. The correlation between distance to ED and the tendency to use ED by inhabitants is negative. If secondary care ED was available there were no life-threatening side-effects at the level of general public health when a minor ED was closed in a primary care ED system.
dc.publisher BioMed Central
dc.subject Distance
dc.subject Emergency department
dc.subject Primary care
dc.subject Suburban
dc.title The effect on the patient flow in local health care services after closing a suburban primary care emergency department: a controlled longitudinal follow-up study
dc.date.updated 2017-12-03T04:24:35Z
dc.language.rfc3066 en
dc.rights.holder The Author(s).
dc.type.uri http://purl.org/eprint/entityType/ScholarlyWork
dc.type.uri http://purl.org/eprint/entityType/Expression
dc.type.uri http://purl.org/eprint/type/JournalArticle

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