Trial reportPrimary health care research & development2026
Economic evaluation of diverting low-risk patients from the emergency department to adjacent out-of-hours primary care in Belgium.
Trial report in Primary health care research & development, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundOut-of-hours primary care (OOH-PC) has been introduced in many health systems to reduce non-urgent emergency department (ED) use. While prior studies suggest potential efficiency gains, economic evaluations rarely stratify outcomes by patient risk, limiting policy relevance. This study assesses the cost-effectiveness of diverting low-risk patients from ED to OOH-PC.
aimCompare direct medical costs, time spent at the facility, and hospitalization probability across risk and care setting subgroups from a societal perspective.
methodsWe analysed data from a cluster-randomized trial conducted in Belgium that examined a nurse-led triage system. Under the study trial's extended Manchester Triage System (eMTS) protocol, patients eligible for primary care were assigned to OOH-PC and are referred to in our study as low-risk, while those assigned to the ED are defined as high-risk. To complement previous work, we stratified costs and effects by risk group. Mixed-effects regression models estimated costs, time at the facility, and hospitalization, with bootstrap confidence intervals. We also calculated the incremental net monetary benefit (INMB).
resultsTreating low-risk patients at the OOH-PC instead of at the ED reduced costs by €24 (€14-€39) per patient, shortened the time spent at the facility by 69 (52-94) minutes. From a societal perspective, the average INMB was €49.5 per low-risk patient. Aggregately, we estimated that the 37 intervention weekends in 2019 led to an average saving of €14,136 in direct medical costs and cumulative time savings of 28 days.
conclusionDiverting low-risk patients from the ED to OOH-PC resulted in cost- and time-savings for low-risk patients at the study site. These findings highlight the potential to improve out-of-hours healthcare delivery to maximize benefits for patients and healthcare systems, although confirmation in other healthcare settings is required before wider implementation.
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