Judging the appropriateness of patients' visits to the emergency department

Physicians and nurses working in a community health centre developed criteria to allow them to judge the appropriateness of their patients' visits to the hospital emergency department. All patient visits to the hospital emergency department were judged by these criteria; 37% of visits were appropriate and 8% were inappropriate. In the remaining 55% agreement was not achieved. The source of disagreement may be related to the problems of giving 24 hour continuing care in family practice. The time of visits to the emergency department and hospitalization rate are different for health centre patients compared to other emergency department users. This may reflect a more appropriate use by health centre patients.