Observational studyBMC health services research2016
Impact of a well-developed primary care system on the length of stay in emergency departments in the Netherlands: a multicenter study.
Observational study in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Emergency department crowding in the Netherlands; evaluation of a real-time ambulance diversion dashboard.International journal of emergency medicine · 2025Article
- Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study.PloS one · 2025Observational
- From symptom onset to ED departure: understanding the acute care chain for patients with undifferentiated complaints: a prospective observational study.International journal of emergency medicine · 2024Article
- Prevalence and risk factors of burden among caregivers of older emergency department patients.Scientific reports · 2023Article
- Primary care access to radiology: Characteristics of trauma patients referred to the emergency department.Journal of evaluation in clinical practice · 2023Observational
- Reduced Emergency Department Utilization During the Early Phase of the COVID-19 Pandemic: Viral Fear or Lockdown Effect?Disaster medicine and public health preparedness · 2022Article
- Portrait of the Emergency Department at Orotta National Referral and Teaching Hospital in Asmara, Eritrea: A Prospective Observational Study.Open access emergency medicine : OAEM · 2022Article
- 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
- Emergency Department to ICU Time Is Associated With Hospital Mortality: A Registry Analysis of 14,788 Patients From Six University Hospitals in The Netherlands.Critical care medicine · 2019Observational
- Factors affecting medical file documentation during telephone triage at an emergency call centre: a cross-sectional study of out-of-hours home visits by general practitioners in France.BMC health services research · 2019Article
- 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
- 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
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Netherlands has a well-developed primary care system, which increasingly collaborates with hospital emergency departments (EDs). In this setting, insight into crowding in EDs is limited. This study explored links between patients' ED Length of Stay (LOS) and their care pathways.
methodsObservational multicenter study of 7000 ED patient records from 1 February 2013. Seven EDs spread over the Netherlands, representing overall Dutch EDs, were included. This included three EDs with and four EDs without an integrated primary-care-physician (PCP) cooperative, forming one Emergency Care Access Point (ECAP). The main outcome was LOS of patients comparing different care pathways (origin and destination of ED attenders).
resultsThe median LOS of ED attenders was 130.0 min (IQR 79.0-140.0), which increased with patients' age. Random coefficient regression analysis showed that LOS for patients referred by medical professionals was 32.9 min longer compared to self-referred patients (95% CI 27.7-38.2 min). LOS for patients admitted to hospital was 41.2 min longer compared to patients followed-up at the outpatient clinic (95% CI 35.3-46.6 min), 49.9 min longer compared to patients followed-up at the PCP (95% CI 41.5-58.3 min) and 44.6 min longer compared to patients who did not receive follow-up (95% CI 38.3-51.0 min). There was no difference in LOS between hospitals with or without an ECAP.
conclusionsWith 130 min, the median LOS in Dutch EDs is relatively short, comparing to other Western countries, which ranges from 176 to 480 min. Although integration of EDs with out-of-hours primary care was not related to LOS, the strong primary care system probably contributed to the overall short LOS of ED patients in the Netherlands.
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