The Family Physician: a Coordinator in the Emergency System

DOI: 10.3238/zfa.2019.0203-0207

german translation / full article

Christina Adamczyk, Markus Huber, Christian Engelbrecht, Lena Kowalski, Linda Sanftenberg, Jörg Schelling, Oliver Abbushi

Keywords: emergency departments emergency patients family physician out-of-hour practices

Background: Currently there are nationwide discussions about an increased number of emergency patients in German emergency departments. Research questions focus on the respective individual role of family physicians (FP). The aim of this study was to analyse the effect of intimate FP involvement in terms of treatment relevance and frequency of referrals to emergency departments . In addition, FP involvement in out-of-hour practices (in hospitals) and treatment relevance should be considered.Methods: With the help of an anonymous questionnaire, socio-demographic data, the presence of a permanent FP, the type of presentation as well as the treatment relevance and referral rate by FPs, were collected. The patients were interviewed personally in eight internal medicine emergency departments and in four out-of-hour practices in Bavaria, Southern Germany.Results: Of a total of 1911 patients surveyed, 91 % had a permanent FP. 47 % of the interviewed patients in the emergency departments had been admitted by FPs/specialists, 53 % were self-presenters or were brought by the rescue service. In out-of-hour practices 93 % were self-presenters, 6 % FP referrals and 1 % back referrals from emergency departments. On average, the relevance of treatment in emergency departments was 70 % and in out-of-hour practices 81 %.Conclusions: FPs plays an important role in the care of emergency patients and can make an important contribution by preselecting and controlling patients, especially with regard to the group of self-presenters. Out-of-hour practices effectively treat emergency patients without life-threatening diagnoses and thus relieve emergency department admissions.

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