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Frequency of in-office emergencies in primary care
Clare Liddy1, Heather Dreise, Isabelle Gaboury
1CT Lamont Primary Health Care Research Centre, Elisabeth Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8. CLiddy@bruyere.org
Objective:
To quantify the frequency and types of in-office emergencies seen by FPs.
Design:
A retrospective descriptive analysis of the frequency and types of in-office emergencies seen by FPs was done using the City of Ottawa Emergency Medical Services database.
Setting:
Community medical offices in the Ottawa, Ont, region during a 3-year period (2004 to 2006).
Participants:
All patients for whom an ambulance was called to a medical office or clinic during the study period.
Main Outcome Measures:
Number of emergency calls from FPs' offices, primary complaints, seasonal variation, distance to the nearest emergency facility, and patients' demographic characteristics.
Results:
A total of 3033 code 04 (life-threatening) emergency calls were received from FPs' offices during the study period. Demographic analysis of the calls showed that 91.3% of calls were regarding adult patients with an average age of 51.5 years. There was an overall statistically significant difference in the sex of the patients presenting (P < .001), but it was attributable to calls about genitourinary emergencies, which were almost all for women. The most common type of emergency reported was cardiovascular complaints. Of the 992 cardiovascular emergencies, 74.3% were complaints of ischemic chest pain.
Conclusion:
There is a great burden on the health care system from emergency calls, with continued unpreparedness from FPs. Clearly, FPs must take seriously the risk of being unprepared for in-office emergencies. Dissemination strategies must be developed so that the guidelines that have been developed can be effectively implemented in FP offices across the country.
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