%0 Journal Article
%T Primary care follow up of patients discharged from the emergency department: a retrospective study
%A Shlomo Vinker
%A Eliezer Kitai
%A Yaacov Or
%A Sasson Nakar
%J BMC Family Practice
%D 2004
%I BioMed Central
%R 10.1186/1471-2296-5-16
%X We retrospectively reviewed all ED discharge summaries for over a month 's period. The ED chart, referral letter and the patient's primary care file were reviewed. Data collected included: age, gender, date and hour of ED visit, documentation of ED referral and ED discharge letter in the primary care file.359 visits were eligible for the study. 192 (53.5%) of the patients were women, average age 54.1 ¡À 18.7 years (mean ¡À SD). 214 (59.6%) of the visits were during working hours of primary care clinics ("working hours"), while the rest were "out of hours" visits. Only 196 (54.6%) of patients had a referral letter, usually from their family physician. A third (71/214) of "working hours" visits were self referrals, the rate rose to 63.5% (92/145) of "out of hours" visits (p < 0.0001). The ED discharge letter was found in 50% (179/359) of the primary care files. A follow-up visit was documented in only 31% (111/359). Neither follow up visit nor discharge letter were found in 43% of the files (153/359).We have found a high rate of ED self referrals throughout the day together with low documentation rates of ED visits in the primary care charts. Our findings point to a poor continuity of care of ED attendees.The emergency department (ED) is intended to treat medical urgencies or emergencies, but a large proportion of visits are due to problems that could be treated in the primary care setting [1,2]. ED services are available 24 hours a day while primary care facilities have limited service hours. In the Israeli health system patients can be referred to the ED by their family practitioner, or by other community health providers, or be self referred. Recently many out of hours community based services have been established but without a significant reduction in visiting rates to in-hospital ED.The visit to the ED constitutes a brief, yet an important point in the continuum of medical care. In today's era of cost effectiveness and increasingly competent primary care physician
%U http://www.biomedcentral.com/1471-2296/5/16