title: Is patient flow more efficient in Urgent Care Collaborations?
abstract: OBJECTIVE
  Emergency Departments and out-of-hours General Practitioner services collaborate increasingly in Urgent Care Collaborations (UCCs) by sharing one combined entrance and joint triage. The aim of this study is to examine the difference between UCCs and providers who operate separately with respect to the efficiency of patient flow.
  
  
  METHODS
  This study had a cross-sectional observational design comparing three regions with UCC with three regions with usual care. Outcome measures were efficiency of patient flow, defined as a reducing length of stay (LOS), waiting time (WT) and the mean number of handovers. Data were obtained from electronic medical records.
  
  
  RESULTS
  LOS (median 34:00 vs. 38:52 min) and WT (median 14:00 vs. 18:43 min) were statistically significantly longer in UCCs compared with usual care. This difference is mainly explained by the prolonged LOS and WT for consulting a General Practitioner. The mean number of interunit handovers was larger in UCCs.
  
  
  CONCLUSIONS
  The results indicate that, on average, UCCs do not enhance the efficiency of patient flow. The median LOS and WT are longer in UCCs and more handovers occur in UCCs compared with usual care.
authors.affiliation: Scientific Center for Transformation in Care and Welfare (Tranzo), Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg.|Out-of-hours General Practitioner service Oost-Brabant, 's-Hertogenbosch.
authors.forename: Elisabeth S J
authors.initials: ESJ
authors.lastname: van Gils-van Rooij
authors.affiliation: Scientific Center for Transformation in Care and Welfare (Tranzo), Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg.
authors.forename: Berthold R
authors.initials: BR
authors.lastname: Meijboom
authors.affiliation: The Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Sjoerd M
authors.initials: SM
authors.lastname: Broekman
authors.affiliation: The Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Christoffel J
authors.initials: CJ
authors.lastname: Yzermans
authors.affiliation: Scientific Center for Transformation in Care and Welfare (Tranzo), Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg.|The Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Dingenus H
authors.initials: DH
authors.lastname: de Bakker
mesh_terms: D000553:Ambulatory Care; D003430:Cross-Sectional Studies; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009426:Netherlands; D009819:Office Visits / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D017749:Total Quality Management / Q000458:organization & administration; D014218:Triage / Q000706:statistics & numerical data