Observational studyBMJ open2025
Patient-reported factors associated with emergency department referrals from a co-located out-of-hours walk-in clinic in Germany: a cross-sectional observational study.
Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The trial behind it
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Who cites it
2 citing papers in PubMed.
- [Age and gender aspects in the utilization of emergency departments and their consideration in the management of emergency care].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Article
- A Descriptive Analysis of GP Referrals to a Model 4 Emergency Department in the West of Ireland.Irish journal of medical science · 2026Observational
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study was to identify patient-reported factors associated with the likelihood of emergency department (ED) referral following treatment at a co-located out-of-hours (OOH) walk-in clinic.
designMonocentric cross-sectional observational study.
settingAn OOH walk-in clinic co-located with the ED of the University Medical Center Hamburg-Eppendorf, Germany. The study period was from November 2019 to February 2020.
participantsA total of 3708 patients attended the walk-in clinic during the study period, with 2574 patients (69.4%) participating in the study.
main outcome measuresWe used logistic regression analysis to calculate adjusted OR (aORs) for patient-reported factors influencing ED referral. The factors examined included reasons for encounter (RFEs), medical history and treatment urgency, categorised according to the International Classification of Primary Care, second edition. Secondary outcomes include descriptive measures of RFE distribution within the study cohort.
resultsThe mean age of participants was 40 years (±15.8), and 54.5% were women. The ED referral rate was 15.2% (n=392). Patient-reported factors that increased the likelihood of ED referral included trauma (aOR 2.61; 95% CI: 1.24 to 5.50), eye symptoms (aOR 2.67; 95% CI: 1.48 to 4.83), abdominal pain (aOR 2.51; 95% CI: 1.74 to 3.64), history of type 2 diabetes (aOR 2.24; 95% CI: 1.18 to 4.25), neurological symptoms (aOR 2.18; 95% CI: 1.24 to 3.84) and higher self-perceived urgency (aOR 1.46; 95% CI: 1.12 to 1.89). Factors that decreased the likelihood of ED referral included respiratory symptoms (aOR 0.58; 95% CI: 0.36 to 0.93), neck/back symptoms (aOR 0.52; 95% CI: 0.31 to 0.88), urinary tract symptoms (aOR 0.18; 95% CI: 0.06 to 0.57) and a duration of the health problem >4 days (aOR 0.72; 95% CI: 0.55 to 0.95).
conclusions10 patient-reported factors of ED referrals were identified. Collecting this information during patient registration may enhance resource utilisation and streamline patient flow between walk-in clinic and adjacent ED. These findings could support the development of triage tools for patients in OOH care.
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