[A closed emergency unit. Consequences for referral patterns and economics]

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.