[Case mix analysis of patients who can be referred from emergency department triage to primary care].
OBJECTIVE
Structured emergency department (ED) triage scales can be used to develop patient referral strategies from the ED to primary care. The objectives of the present study were to evaluate the percentage of patients who could potentially be referred from triage to primary care and to describe their clinical characteristics.


METHODS
We analyzed all patients with low acuity (triage levels IV and V) and low complexity (patients discharged from the ED) triaged during 2003 with the Andorran Triage Model in the ED and estimated the percentage of patients who could potentially be referred on the basis of three primary care models: A, centers unable to deal with emergencies or perform complementary investigations; B, centers able to deal with emergencies and perform complementary investigations, and C, centers able to deal with emergencies but unable to perform complementary investigations.


RESULTS
Of the 25,319 patients included in the study, 5.63% could be referred to model A, 75.22% to model B and 33.36% to model C. A total of 81.04% of these model C patients were classified in seven symptomatic categories: wounds and traumatisms, inflammation or fever, pediatric problems, rhinolaryngological infection or alterations, ocular symptoms, pain and cutaneous allergy or reactions.


CONCLUSIONS
Casemix analysis, based on the level of acuity and discharge criteria, can be used to establish the percentage of patients that could potentially be referred to primary care. Analysis of their clinical profile is useful to design referral protocols.
Gómez-Jiménez
Josep
J
Servei d'Urgències, Hospital Nostra Senyora de Meritxell, Servei Andorrà d'Atenció Sanitària (SAAS), Les Escaldes-Engordany, Principat d'Andorra. jgomez@andorra.ad
Becerra
Oscar
O
Boneu
Francisco
F
Burgués
Lluís
L
Pàmies
Salvador
S
D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D006801:Humans; D011320:Primary Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013030:Spain; D014218:Triage / Q000706:statistics & numerical data*