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[A closed emergency unit. Consequences for referral patterns and economics]
N Wedderkopp1, B L Rosenblad, H Münster
1Faaborg Sygehus, kirurgisk afdeling.
Insights
The Faaborg Hospital emergency department changed to semi-closed in the mid-1980s, requiring general practitioner referrals. This evaluation found no change in patient types but increased costs for the National Health Service.
Area of Science:
- Health Services Research
- Healthcare Management
- Public Health Policy
Context:
- The mid-1980s saw Faaborg Hospital's emergency department transition from an open to a semi-closed model.
- This change mandated that patients first contact a general practitioner (GP) for a referral to the emergency department.
- The established general practices were intended to fulfill a crucial referring function within this new system.
Purpose:
- To evaluate the consequences of the semi-closed emergency department policy implemented in the mid-1980s.
- To assess the impact of the mandatory GP referral system on emergency room patient demographics and healthcare costs.
- To determine the effectiveness and economic implications of this healthcare system modification.
Summary:
- A study conducted between August 25 and December 1, 1991, registered all patients accessing the emergency department.
- Analysis revealed no significant alterations in the types of patients presenting at the emergency department post-policy change.
- The findings indicated that the new semi-closed system resulted in increased operational costs for the National Health Service.
Impact:
- The study suggests that the semi-closed emergency department model, despite its intentions, did not alter patient case mix.
- The policy change led to a demonstrable increase in financial burden on the National Health Service.
- This research provides valuable insights into the cost-effectiveness and patient flow management of semi-closed emergency department systems.
Abstract:
During the mid 1980's the emergency-room at Faaborg Hospital changed status from being open to semi-closed. From then on the patients had to contact a general practitioner before going to the emergency-room. The general practices in the area were then supposed to have a referring function. We decided to evaluate the consequences of this decision in 1991. From 25 August to 1 December 1991 we registered all patients who contacted the emergency-room. The conclusions were that no changes in the types of patients had occurred, and that it was at a greater cost to the National Health Service.