ArticleEmergency medicine international2013
The impact on emergency department utilization and patient flows after integrating with a general practitioner cooperative: an observational study.
Article in Emergency medicine international, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- How do interventions in primary care or in emergency departments impact less urgent patients' emergency care utilization? A systematic review.BMC health services research · 2026Pooled it
- Motives for self-referral to the emergency department: a systematic review of the literature.BMC health services research · 2016Pooled it
- [Efficiency of streaming and integrated care models for low acuity patients in acute and emergency care-results from a prospective cohort study].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Article
- Review
- Patient navigation in German emergency care (NODE). Study protocol of a multi-center mixed-methods trial.Frontiers in health services · 2025Article
- Primary care access to radiology: Characteristics of trauma patients referred to the emergency department.Journal of evaluation in clinical practice · 2023Observational
- Realist analysis of whether emergency departments with primary care services generate 'provider-induced demand'.BMC emergency medicine · 2022Article
- Safety assessment of a redirection program using an electronic application for low-acuity patients visiting an emergency department.BMC emergency medicine · 2022Observational
- Effects of access to radiology in out-of-hours primary care on patient satisfaction and length of stay.The European journal of general practice · 2021Observational
- Differences between recorded diagnoses of patients of an emergency department and office-hours primary care doctors: a register-based study in a Finnish town.International journal of circumpolar health · 2021Article
- Barriers to Integration of Primary Care into Emergency Care: Experiences in Germany.International journal of integrated care · 2021Article
- Self-referred walk-in patients in the emergency department - who and why? Consultation determinants in a multicenter study of respiratory patients in Berlin, Germany.BMC health services research · 2020Article
- Emergency department clinical leads' experiences of implementing primary care services where GPs work in or alongside emergency departments in the UK: a qualitative study.BMC emergency medicine · 2020Article
- The impact of general practitioners working in or alongside emergency departments: a rapid realist review.BMJ open · 2019Review
- Article
- Influence of social characteristics on use of paediatric emergency care in Sweden - a questionnaire based study.BMC emergency medicine · 2018Article
- Does X-ray imaging by GPC at emergency care access points in the Netherlands change patient flow and reduce ED crowding? A cohort study.Health science reports · 2018Article
- Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department.Journal of primary care & community health · 2017Article
- Collaboration in teams with nurse practitioners and general practitioners during out-of-hours and implications for patient care; a qualitative study.BMC health services research · 2017Article
- Patient and care characteristics of self-referrals treated by the general practitioner cooperative at emergency-care-access-points in the Netherlands.BMC family practice · 2017Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction. A new model, an emergency care access point (ECAP) for after-hours emergency care, is emerging in The Netherlands. This study assessed the effect on emergency department (ED) utilization and patient flows. Methods. Routinely recorded clinical ED patient data, covering a six-year period, was collected. Segmented regression analysis was used to analyze after-hours changes over time. Results. 59.182 patients attended the ED before the start of the ECAP and 51.513 patients after, a decrease of 13%. Self-referred ED patients decreased 99.5% (OR 0.003; 95% CI 0.002-0.004). Referred patients increased by 213.4% and ED hospital admissions increased by 20.2%. A planned outpatient follow-up increased by 5.8% (OR 1.968 95% CI 1.870-2.071). The latter changed from fewer contacts to more contacts (OR 1.015 95% CI 1.013-1.017). Consultations at the regional genereral practitioner cooperative (GPC) increased by 26.0% (183.782 versus 232.246). Conclusion. ECAP implementation resulted in a decrease in ED utilization, a near absence of self-referring patients, and a higher probability of hospital admission and clinical follow-up. This suggests either an increase of ED patients with a higher acuity or a lower threshold of admitting referred patients compared to self-referred patients. Overall, increased collaboration with after-hours primary care and emergency care seemed to optimize ED utilization.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.