A Primary Care Emergency Service Reduction Did Not Increase Office-Hour Service Use : A Longitudinal Follow-up Study

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dc.contributor.author Lehto, Mika
dc.contributor.author Mustonen, Katri
dc.contributor.author Kantonen, Jarmo
dc.contributor.author Raina, Marko
dc.contributor.author Heikkinen, Anna-Maria K.
dc.contributor.author Kauppila, Timo
dc.date.accessioned 2019-10-21T06:16:01Z
dc.date.available 2019-10-21T06:16:01Z
dc.date.issued 2019-07
dc.identifier.citation Lehto , M , Mustonen , K , Kantonen , J , Raina , M , Heikkinen , A-M K & Kauppila , T 2019 , ' A Primary Care Emergency Service Reduction Did Not Increase Office-Hour Service Use : A Longitudinal Follow-up Study ' , Journal of Primary Care & Community Health , vol. 10 , 2150132719865151 . https://doi.org/10.1177/2150132719865151
dc.identifier.other PURE: 127546965
dc.identifier.other PURE UUID: d1acb1f5-e918-49cf-85e1-716c4b12b153
dc.identifier.other WOS: 000477855800001
dc.identifier.other ORCID: /0000-0003-3252-192X/work/88210019
dc.identifier.uri http://hdl.handle.net/10138/306215
dc.description.abstract This study, conducted in a Finnish city, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hour primary care would guide patients to office-hour visits to general practitioners (GP). This was an observational retrospective study based on a before-and-after design carried out by gradually decreasing ED services in primary care. The interventions were (a) application of ABCDE-triage combined with public guidance on the proper use of EDs, (b) cessation of a minor supplementary ED, and finally (c) application of "reverse triage" with enhanced direction of the public to office-hour services from the remaining ED. The numbers of visits to office-hour primary care GPs in a month were recorded before applying the interventions fully (preintervention period) and in the postintervention period. The putative effect of the interventions on the development rate of mortality in different age groups was also studied as a measure of safety. The total number of monthly visits to office-hour GPs decreased slowly over the whole study period without difference in this rate between pre- and postintervention periods. The numbers of office-hour GP visits per 1000 inhabitants decreased similarly. The rate of monthly visits to office-hour GP/per GP did not change in the preintervention period but decreased in the postintervention period. There was no increase in the mortality in any of the studied age groups (0-19, 20-64, 65+ years) after application of the ED interventions. There is no guarantee that decreasing activity in a primary care ED and consecutive enhanced redirecting of patients to the office-hour primary care systems would shift patients to office-hour GPs. On the other hand, this decrease in the ED activity does not seem to increase mortality either. en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof Journal of Primary Care & Community Health
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject community health centers
dc.subject emergency department
dc.subject primary care
dc.subject practice management
dc.subject mortality
dc.subject 3142 Public health care science, environmental and occupational health
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.title A Primary Care Emergency Service Reduction Did Not Increase Office-Hour Service Use : A Longitudinal Follow-up Study en
dc.type Article
dc.contributor.organization University of Helsinki
dc.contributor.organization Department of General Practice and Primary Health Care
dc.contributor.organization Staff Services
dc.contributor.organization HUS Head and Neck Center
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1177/2150132719865151
dc.relation.issn 2150-1319
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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