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[General Practice in a University Emergency Department - Concept, Implementation and Evaluation].

T Schleef1, N Schneider1, A Tecklenburg2

  • 1Medizinische Hochschule Hannover, Institut für Allgemeinmedizin, Hannover.

Gesundheitswesen (Bundesverband Der Arzte Des Offentlichen Gesundheitsdienstes (Germany))
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Summary

Integrating general practitioners (GPs) into accident and emergency departments (A&E) effectively manages rising patient numbers. This approach shows promise for improving A&E efficiency and patient care.

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Area of Science:

  • Emergency Medicine
  • Primary Care Integration
  • Healthcare Management

Background:

  • Accident and emergency (A&E) departments face escalating patient volumes.
  • Hospitalization rates remain stable, but outpatient cases have increased.
  • Hannover Medical School (MHH) integrated general practitioners (GPs) into A&E services.

Purpose of the Study:

  • To evaluate the impact and outcomes of integrating general practitioners (GPs) within an accident and emergency (A&E) department.
  • To assess patient referral sources, diagnoses, and disposition decisions made by GPs in the A&E setting.

Main Methods:

  • Analysis of routine hospital data and a dedicated questionnaire for GP contacts in A&E during 2014.
  • Data collection focused on admission initiation, medical assessments, diagnostic tests, and patient disposition decisions.

Main Results:

  • GPs in A&E treated 1,646 patients in 2014, with 76% self-referrals and 23% referred by primary care physicians.
  • Common diagnoses included back pain, gastroenteritis, and hypertension; most cases did not require specialist intervention.
  • 81% of patients were discharged, with most advised to follow up with their GP (59%) or a specialist (22%); repeat visits were infrequent.

Conclusions:

  • The integration of general practitioners (GPs) into accident and emergency (A&E) departments is a viable strategy for managing increased patient flow.
  • Further research is recommended to validate diagnostic accuracy and assess patient satisfaction with GP-led A&E care.