title: [General Practice in a University Emergency Department - Concept, Implementation and Evaluation].
abstract: Background:Accident and emergency departments (A&E) are facing increasing numbers of patients. While hospitalization rates have remained nearly constant, there has been an increase in outpatient cases. Therefore, at Hannover Medical School (MHH), general practitioners (GPs) have been integrated in A&E.Methods:In 2014, all GP contacts within the A&E were evaluated on the basis of hospital routine data and by an additional questionnaire. It contained questions about who initiated the admission, about medical examinations and tests and the patient-related admission decisions.Results:In 2014, GPs in A&E treated 1 646 patients. 76% of the patients were self-referrals and 23% referrals from primary care physicians. The most prevalent diagnoses were back pain, gastroenteritis and hypertension. GPs in A&E did not need any additional specialist involvement in most cases. 81% of the patients were sent home, most of them with the advice to consult their GPs (59%), and 22% to consult a specialist. Repeated visits were scarce.Conclusion:Deploying GPs in A&E represents a promising concept to cope with the rising number of patients in A&E. However, further studies are needed to examine the accuracy of the GPs' diagnosis-related decisions and patient satisfaction.
authors.affiliation: Medizinische Hochschule Hannover, Institut für Allgemeinmedizin, Hannover.
authors.forename: T
authors.initials: T
authors.lastname: Schleef
authors.affiliation: Medizinische Hochschule Hannover, Institut für Allgemeinmedizin, Hannover.
authors.forename: N
authors.initials: N
authors.lastname: Schneider
authors.affiliation: Medizinische Hochschule Hannover, Präsidium, Hannover.
authors.forename: A
authors.initials: A
authors.lastname: Tecklenburg
authors.affiliation: Medizinische Hochschule Hannover, Institut für Allgemeinmedizin, Hannover.
authors.forename: U
authors.initials: U
authors.lastname: Junius-Walker
authors.affiliation: Medizinische Hochschule Hannover, Institut für Allgemeinmedizin, Hannover.
authors.forename: O
authors.initials: O
authors.lastname: Krause
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000458:organization & administration*; D006284:Health Plan Implementation / Q000458:organization & administration*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D014600:Utilization Review; D055815:Young Adult