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Impact of a well-developed primary care system on the length of stay in emergency departments in the Netherlands: a multicenter study

Overview of attention for article published in BMC Health Services Research, April 2016
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Title
Impact of a well-developed primary care system on the length of stay in emergency departments in the Netherlands: a multicenter study
Published in
BMC Health Services Research, April 2016
DOI 10.1186/s12913-016-1400-z
Pubmed ID
Authors

Wendy A. M. H. Thijssen, Nicole Kraaijvanger, Dennis G. Barten, Marleen L. M. Boerma, Paul Giesen, Michel Wensing

Abstract

The Netherlands has a well-developed primary care system, which increasingly collaborates with hospital emergency departments (EDs). In this setting, insight into crowding in EDs is limited. This study explored links between patients' ED Length of Stay (LOS) and their care pathways. Observational multicenter study of 7000 ED patient records from 1 February 2013. Seven EDs spread over the Netherlands, representing overall Dutch EDs, were included. This included three EDs with and four EDs without an integrated primary-care-physician (PCP) cooperative, forming one Emergency Care Access Point (ECAP). The main outcome was LOS of patients comparing different care pathways (origin and destination of ED attenders). The median LOS of ED attenders was 130.0 min (IQR 79.0-140.0), which increased with patients' age. Random coefficient regression analysis showed that LOS for patients referred by medical professionals was 32.9 min longer compared to self-referred patients (95 % CI 27.7-38.2 min). LOS for patients admitted to hospital was 41.2 min longer compared to patients followed-up at the outpatient clinic (95 % CI 35.3-46.6 min), 49.9 min longer compared to patients followed-up at the PCP (95 % CI 41.5-58.3 min) and 44.6 min longer compared to patients who did not receive follow-up (95 % CI 38.3-51.0 min). There was no difference in LOS between hospitals with or without an ECAP. With 130 min, the median LOS in Dutch EDs is relatively short, comparing to other Western countries, which ranges from 176 to 480 min. Although integration of EDs with out-of-hours primary care was not related to LOS, the strong primary care system probably contributed to the overall short LOS of ED patients in the Netherlands.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 62 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 62 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 32%
Researcher 6 10%
Student > Bachelor 5 8%
Student > Doctoral Student 3 5%
Student > Ph. D. Student 3 5%
Other 7 11%
Unknown 18 29%
Readers by discipline Count As %
Medicine and Dentistry 21 34%
Nursing and Health Professions 17 27%
Biochemistry, Genetics and Molecular Biology 1 2%
Social Sciences 1 2%
Economics, Econometrics and Finance 1 2%
Other 0 0%
Unknown 21 34%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 October 2016.
All research outputs
#20,452,106
of 25,134,448 outputs
Outputs from BMC Health Services Research
#7,279
of 8,531 outputs
Outputs of similar age
#226,984
of 305,077 outputs
Outputs of similar age from BMC Health Services Research
#74
of 84 outputs
Altmetric has tracked 25,134,448 research outputs across all sources so far. This one is in the 10th percentile – i.e., 10% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,531 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
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We're also able to compare this research output to 84 others from the same source and published within six weeks on either side of this one. This one is in the 5th percentile – i.e., 5% of its contemporaries scored the same or lower than it.