CORE
🇺🇦
make metadata, not war
Services
Services overview
Explore all CORE services
Access to raw data
API
Dataset
FastSync
Content discovery
Recommender
Discovery
OAI identifiers
OAI Resolver
Managing content
Dashboard
Bespoke contracts
Consultancy services
Support us
Support us
Membership
Sponsorship
Community governance
Advisory Board
Board of supporters
Research network
About
About us
Our mission
Team
Blog
FAQs
Contact us
Self-referring patients at the emergency department: appropriateness of ED use and motives for self-referral
Authors
R de Haan
JC Goslings
+6 more
RC Lam
R Lindeboom
C Lucas
CL van den Brand
MC van der Linden
N van der Linden
Publication date
16 July 2014
Publisher
'Springer Science and Business Media LLC'
Doi
Cite
View
on
PubMed
Abstract
© 2014, van der Linden et al.; licensee Springer. Background: Nearly all Dutch citizens have a general practitioner (GP), acting as a gatekeeper to secondary care. Some patients bypass the GP and present to the emergency department (ED). To make best use of existing emergency care, Dutch health policy makers and insurance companies have proposed the integration of EDs and GP cooperatives (GPCs) into one facility. In this study, we examined ED use and assessed the characteristics of self-referrals and non-self-referrals, their need for hospital emergency care and self-referrals' motives for presenting at the ED. Methods: A descriptive cohort study was conducted in a Dutch level 1 trauma centre. Differences in patient characteristics, time of presentation and need for hospital emergency care were analysed using χ2 tests and t tests. A patient was considered to need hospital emergency care when he/she was admitted to the hospital, had an extremity fracture and/or when diagnostic tests were performed. Main determinants of self-referral were identified via logistic regression. Results: Of the 5,003 consecutive ED patients registering within the 5-week study period, 3,028 (60.5%) were self-referrals. Thirty-nine percent of the self-referrals had urgent acuity levels, as opposed to 65% of the non-self-referrals. Self-referrals more often suffered from injuries (49 vs. 20%). One third of the self-referrals presented during office hours. Of all self-referrals, 51% needed hospital emergency care. Younger age; non-urgent acuity level; chest pain, ear, nose or throat problems; and injuries were independent predictors for self-referral. Most cited motives for self-referring were ‘accessibility and convenience’ and perceived ‘medical necessity’. Conclusions: A substantial part of the self-referrals needed hospital emergency care. The 49% self-referrals who were eligible for GP care presented during out-of-hours as well as during office hours. This calls for an integrative approach to this health care problem
Similar works
Full text
Open in the Core reader
Download PDF
Available Versions
NARCIS
See this paper in CORE
Go to the repository landing page
Download from data provider
Last time updated on 30/06/2023
Erasmus University Digital Repository
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:repub.eur.nl:62604
Last time updated on 04/08/2016
Springer - Publisher Connector
See this paper in CORE
Go to the repository landing page
Download from data provider
Last time updated on 30/04/2017
EUR Research Repository
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:pure.eur.nl:publications/f...
Last time updated on 22/08/2023
Crossref
See this paper in CORE
Go to the repository landing page
Download from data provider
info:doi/10.1186%2Fs12245-014-...
Last time updated on 05/06/2019
OPUS - University of Technology Sydney
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:opus.lib.uts.edu.au:10453/...
Last time updated on 18/10/2019
EUR Research Repository
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:pure.eur.nl:openaire_cris_...
Last time updated on 22/08/2023
Springer - Publisher Connector
See this paper in CORE
Go to the repository landing page
Download from data provider
Last time updated on 05/06/2019
NARCIS
See this paper in CORE
Go to the repository landing page
Download from data provider
Last time updated on 16/12/2017