+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

The impact of a primary care physician cooperative on the caseload of an emergency department: the Maastricht integrated out-of-hours service

, : The impact of a primary care physician cooperative on the caseload of an emergency department: the Maastricht integrated out-of-hours service. Journal of General Internal Medicine 20(7): 612-617

OBJECTIVE: To determine the effect of an out-of-hours primary care physician (PCP) cooperative on the caseload at the emergency department (ED) and to study characteristics of patients utilizing out-of-hours care.DESIGN: A pre-post intervention design was used. During a 3-week period before and a 3-week period after establishing the PCP cooperative, all patient records with out-of-hours primary and emergency care were analyzed.SETTING: Primary care in Maastricht ( the Netherlands) is delivered by 59 PCPs. Primary care physicians formerly organized out-of-hours care in small locum groups. In January 2000, out- of- hours primary care was reorganized, and a PCP cooperative was established. This cooperative is located at the ED of the University Hospital Maastricht, the city's only hospital, which has no emergency medicine specialists.MAIN OUTCOME MEASURES: The number of patients utilizing out- of-hours care, their age and sex, diagnoses, post-ED care, and serious adverse events.RESULTS. After establishing the PCP cooperative, the proportion of patients utilizing emergency care decreased by 53%, and the proportion of patients utilizing primary care increased by 25%. The shift was the largest for patients with musculoskeletal disorders or skin problems. There were fewer hospital admissions, and fewer subsequent referrals to the patient's own PCP and medical specialists. No substantial change in new outpatient visits at the hospital or in mortality occurred.CONCLUSIONS: In the city of Maastricht, the Netherlands, the PCP cooperative reduced the use of hospital emergency care during out-of-hours care.


PMID: 16050847

DOI: 10.1111/j.1525-1497.2005.0091.x

Other references

Galindo G.G.; Honorato P.R.; Millan A.R., 1987: Dispersion of some andisols of Chile by sodium hexametaphosphate and zirconium nitrate. In a comparison of sodium hexametaphosphate and zirconium nitrate as reagents for the dispersion of the A horizon of typical Andisols of Chile with ultrasonic or mechanical shaking, best results were obtained with zirconium nitrate under ultrasoni...

Nathanson, I., 2001: Interview with an insider: how to pursue a successful old age. Interview by Judith McFadden. Pennsylvania Dental Journal 67(3): 17-22

Lanzara, V.; Cervellati, F.; Grazi, E., 1988: On the interaction between xanthine oxidase and actin. Xanthine oxidase increases the rate of actin polymerization. This occurs at oxidase concentrations as low as 40 nM provided the concentration of the polymerizing agent is low (0.5 mM MgCl2). In the presence of 0.1 M KCl plus 1 mM MgCl2 as the poly...

Dullaart, R.P.F.; Pasterkamp, S.H.; Beentjes, J.A.M.; Sluiter, W.J., 1999: Evaluation of adrenal function in patients with hypothalamic and pituitary disorders: Comparison of serum cortisol, urinary free cortisol and the human-corticotrophin releasing hormone test with the insulin tolerance test. OBJECTIVE This study aimed to evaluate the performance of screening tests (serum cortisol and 24-h urinary free cortisol) and the human-corticotrophin releasing hormone (h-CRH) test in the assessment of adrenal function in patients with hypothalam...

Dier, K.; Whittier, A.; Fink, C.A.; Lopez, L.R., 1999: Detection of antiphospholipid antibodies Efficient evaluation of hypercoagulable states. Clinical Chemistry 45(6 PART 2): A78, June

Zerbi, A.; Capitanio, V.; Boninsegna, L.; Pasquali, C.; Rindi, G.; Delle Fave, G.; Del Chiaro, M.; Casadei, R.; Falconi, M.; D.C.rlo, V.; Pederzoli, P.; Delle Fave, G.; Pedrazzoli, S.; Tomassetti, P.; Casadei, R.; Garcea, D.; Uomo, G.; Colangelo, E.; Mosca, F.; Fronda, G.Ruggero.; Bresadola, F.; Cantore, M.; Leone, B.Eugenio.; Farinati, F.; Toma, S.Salvatore.; Luppi, G.; Bene, A.; Bajetta, E.; Ruffini, L.; Gebbia, V.; Liguori, L.;, G.; Dogliotti, L.; Massidda, B., 2011: Surgical treatment of pancreatic endocrine tumours in Italy: results of a prospective multicentre study of 262 cases. Information on the treatment of pancreatic endocrine tumours (PETs) comes mostly from small, retrospective, uncontrolled studies. Newly diagnosed, histologically proven PETs, observed from June 2004 to March 2007 in 24 Italian centres, were includ...

Mironov, A.A.; Mironov, A.A., 1998: Estimation of subcellular organelle volume from ultrathin sections through centrioles with a discretized version of the vertical rotator. A method for the fast and efficient estimation of the volume (but not surface area) of subcellular organelles is presented. It consists of a rotator/coaxial-section approach based on the Pappus theorem and represents a discretized version of the v...

Cebrian, E.; Rodríguez-Prieto, C., 2012: Marine invasion in the Mediterranean Sea: the role of abiotic factors when there is no biological resistance. The tropical red alga Womersleyella setacea (Rhodomelaceae, Rhodophyta) is causing increasing concern in the Mediterranean Sea because of its invasive behavior. After its introduction it has colonized most Mediterranean areas, but the mechanism un...

Ermonval, M.; Cacan, R.; Gorgas, K.; Haas, I.G.; Verbert, A.; Buttin, G., 1997: Differential fate of glycoproteins carrying a monoglucosylated form of truncated N-glycan in a new CHO line, MadIA214214, selected for a thermosensitive secretory defect. A temperature sensitive secretory line, MadIA214, was selected from mutagenized Chinese hamster ovary cells that express two heterologous export marker proteins: a secretory form of the human placental alkaline phosphatase (SeAP), and the Kd heavy...

Meyer, M., 1982: Schwertlose Xiphophorus Heckel, 1848. Aquarium (Bornheim): 16156: 300-306