Emergency department patient characteristics: Potential impact on emergency medicine residency programs in the Netherlands.
OBJECTIVE
We set out to study emergency department patient characteristics at a busy level-2 trauma center, to gain insight into the practise of emergency medicine, which is not yet recognized as a specialty in the Netherlands.


METHODS
From May 27 to July 4 2001, the following data were recorded from the charts of all patients presenting to the emergency department: age, time and form of presentation, diagnostics, treatment, disposition and the single best diagnosis (International Classification of Disease-10 classification).


RESULTS
The majority (84%) of the 5234 patients (134/day) patients seen were self-referred and treated by the emergency department physician. The remaining 16% were referred, usually by their general practitioner, directly to a specialty service, which saw them in the emergency department. Self-referred patients tended to be younger (average 33 years), with minor trauma, and infrequently required diagnostics (37%), treatment (49%) or admission (4%). The referred patients were older (average 50 years), with 41% needing admission. Only 16% of all patients were under 16 years of age. In all, there were five deaths (referred patients), 12 resuscitations, seven intubations, seven chest tube insertions and no lumbar punctures performed during the study period.


CONCLUSIONS
The acuity of self-referred patients seen by the emergency physicians is low, with little diagnostic testing and few interventions and resuscitations, even in a busy center. This has both training and practise implications and it may be inappropriate to take an emergency medicine practise model or curriculum from another country based on its emergency department population.
Elshove-Bolk
Jolande
J
Haukeland University Hospital, Bergen, Norway. jhwelshove@c2i.net
Mencl
Francis
F
van Rijswijck
Bas T F
BT
Weiss
Ilanit M
IM
Simons
Maarten P
MP
van Vugt
Arie B
AB
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D004635:Emergency Medicine / Q000193:education / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006302:Health Services Research; D017052:Hospital Mortality; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency / Q000458:organization & administration*; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008875:Middle Aged; D017145:Models, Educational; D020380:Needs Assessment; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012151:Resuscitation / Q000706:statistics & numerical data; D013907:Thoracostomy / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000706:statistics & numerical data