Evidence map›Paper›PMID 36894178›Full record

ArticleBMJ open quality2023

Evaluating emergency department transfers from urgent care centres: insights for paramedic integration with subacute healthcare.

Ryan P Strum, Fabrice I Mowbray, Shawn E Mondoux, Andrew P Costa

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Ryan P StrumHealth Research, Evidence and Impact, McMaster University, Hamilton, New Zealand, Canada strumr@mcmaster.ca.ORCID 0000-0003-1902-4734
Fabrice I MowbrayHealth Research, Evidence and Impact, McMaster University, Hamilton, New Zealand, Canada.
Shawn E MondouxMedicine, Division of Emergency Medicine, McMaster University, Hamilton, New Zealand, Canada.
Andrew P CostaHealth Research, Evidence and Impact, McMaster University, Hamilton, New Zealand, Canada.
Impact · CAMcMaster University · CA

Funding

University of Wisconsin Institute for Clinical and Translational ResearchUL1TR002373 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI ELIZABETH S BURNSIDE, Allan R. Brasier · 2017 to 2026
$75.9M
Institutional Career Development CoreKL2TR002374 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI Bo Liu, Marin Leigh Schweizer · 2017 to 2026
$9.7M
6 · The paper itself

Abstract

objectiveParamedics redirecting non-emergent patients from emergency departments (EDs) to urgent care centres is a new and forthcoming strategy to reduce overcrowding and improve primary care integration. Which patients are likely not suitable for paramedic redirection are unknown. To describe and specify patients inappropriate for urgent care centres, we examined associations between patient characteristics and transfer to the ED after patients initially presented to an urgent care centre.

methodsA population-based retrospective cohort study of all adult (≥18 years) visits to an urgent care centre from 1 April 2015 to 31 March 2020 in Ontario, Canada. Binary logistic regression was used to determine unadjusted and adjusted associations between patient characteristics and being transferred to an ED using OR and 95% CIs. We calculated the absolute risk difference for the adjusted model.

resultsA total of 1 448 621 urgent care visits were reported, with 63 343 (4.4%) visits transferred to an ED for definitive care. Being 65 years and older (OR 2.29, 95% CI 2.23 to 2.35), scored an emergent Canadian Triage and Acuity Scale of 1 or 2 (OR 14.27, 95% CI 13.45 to 15.12) and higher comorbidity count (OR 1.51, 95% CI 1.46 to 1.58) had added odds of association with being transferred out to an ED.

conclusionReadily available patient characteristics were independently associated with interfacility transfers between urgent care centres and the ED. This study can support paramedic redirection protocol development, highlighting which patients may not be best suited for ED redirection.

Indexed as

Emergency Service, HospitalParamedicsAdultAmbulatory Care FacilitiesDelivery of Health CareHumansOntarioRetrospective StudiesAmbulancesAmbulatory careElectronic Health RecordsEmergency departmentHealth services research

Identifiers

PMID36894178
PMCPMC10008425
OpenAlexW4323666520

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.