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Primary care emergency services utilization in German-speaking Switzerland: a population-based cross-sectional study
Urs Güntensperger1, Rosmarie Pinzello-Hürlimann, Benedict Martina
1Büli Aerzte, Bülach, Switzerland. urs.guentensperger@hin.ch
Swiss Medical Weekly
|November 3, 2010
Summary
Emergency primary care utilization is shifting from general practitioners (GPs) to hospitals. Hospitals see older patients with longer wait times for emergency consultations compared to GPs.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Emergency consultations traditionally managed by general practitioners (GPs) in Switzerland.
- Observed shift in emergency care utilization from general practice to hospital emergency wards.
- Need for population-based data to plan new emergency care organizational models.
Purpose of the Study:
- Investigate the epidemiology and distribution of emergency consultations in primary care settings (hospital vs. GP).
- Analyze factors influencing clinical performance in emergency consultations.
- Provide data for effective emergency care planning.
Main Methods:
- Survey of all emergency patient contacts with GPs and hospital emergency wards in Bülach catchment area (27,088 inhabitants).
- Data collection during Q4 2006, including patient demographics, contact time, duration, and triage diagnosis.
- Calculation of contact and hospitalization rates per 100,000 inhabitants.
- Multiple linear regression to identify factors associated with consultation time.
Main Results:
- 1001 patient contacts registered; contact rate of 94.8 per 100,000 inhabitants/day.
- Hospital patients were older (41.2 years) than GP patients (32.6 years).
- Hospital consultations and waiting times were significantly longer (144.8 min) than with GPs (19.6 min).
Conclusions:
- Approximately 1 in 1000 inhabitants sought emergency primary care.
- 10% of patients required urgent care and hospitalization.
- GPs manage infections, trauma, and ENT issues; hospitals see trauma, thoracic pain, and infections, with GPs offering faster consultations.
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