
Barriers to Integration of Primary Care into Emergency Care: Experiences in Germany
By: Andrew Dickinson and Stefanie Joos
References
- Berchet C.
Emergency Care Services: Trends, Drivers and Interventions to Manage the Demand . OECD Health Working Papers, No. 83, Paris: OECD Publishing. (2015), [cited 2020 13 Jul]. DOI: 10.1787/5jrts344crns-en. - Maibach-Nagel E. Notfallversorgung: Mediation für gemeinsame Lösung [Emergency care: Mediation for a common solution]. Deutsches Aerzteblatt, 2017; 114(20): A-932 / B-782 / C-64 [in German].
- Schmiedhofer M, Möckel M, Slagman A, Frick J, Ruhla S, Searle J. Patient motives behind low-acuity visits to the emergency department in Germany: a qualitative study comparing urban and rural sites. BMJ Open. 2016 Nov 16; 6(11):
e013323 . DOI: 10.1136/bmjopen-2016-013323. - Crawford J, Cooper S, Cant R, DeSouza R. The impact of walk-in centres and GP co-operatives on emergency department presentations: A systematic review of the literature. International Emergency Nursing. 2017 Sep; 34: 36–42. DOI: 10.1016/j.ienj.2017.04.002.
- Turner J, Coster J, Chambers D, Cantrell A, Phung VH, Knowles E, Bradbury D, Goyder E.
What evidence is there on the effectiveness of different models of delivering urgent care? A rapid review. Southampton, UK: NIHR Journals Library; 2015 Nov. DOI: 10.3310/hsdr03430 - Khangura JK, Flodgren G, Perera R, Rowe BH, Shepperd S. Primary care professionals providing non-urgent care in hospital emergency departments. Cochrane Database of Systematic Reviews. 2012 Nov 14; 11: CD002097. DOI: 10.1002/14651858.CD002097.pub3.
- Lacobucci G. All emergency departments must have GP led triage by October. British Medical Journal, 2017; 356: j1270. DOI: 10.1136/bmj.j1270
- Government to expand GP streaming service as ‘10%’ of A&E patients diverted. Pulse UK [serial online]. 2020 Feb 18 [cited 2020 Feb 24]. Available from:
https://www.pulsetoday.co.uk/news/uncategorised/government-to-expand-gp-streaming-service-as-10-of-ae-patients-diverted/ . - Ramlakhan S, Mason S, O’Keeffe C, Ramtahal A, Ablard S. Primary care services located with EDs: a review of effectiveness. Emergency Medical Journal, 2016 Jul; 33(7): 495–503. DOI: 10.1136/emermed-2015-204900.
- Gonçalves-Bradley D, Khangura JK, Flodgren G, Perera R, Rowe BH, Shepperd S. Primary care professionals providing non-urgent care in hospital emergency departments (Review). Cochrane Database of Systematic Reviews, 2018; 2(Art. No.): CD002097. DOI: 10.1002/14651858.CD002097.pub4.
- Thijssen WA, Wijnen-van Houts M, Koetsenruijter J, Giesen P, Wensing M. The impact on emergency department utilization and patient flows after integrating with a general practitioner cooperative: an observational study. Emergency Medicine International, 2013; 2013:
364659 . DOI: 10.1155/2013/364659 - Kodner DL, Spreeuwenberg C. Integrated care: meaning, logic, applications, and implications-a discussion paper. International Journal of Integrated Care, 2002; 2:
e12 . DOI: 10.5334/ijic.67 - Kodner DL. All together now: a conceptual exploration of integrated care. Healthcare Quarterly. 2009; 13 Spec No: 6–15. DOI: 10.12927/hcq.2009.21091
- Beneker C. Hausärzte in der Notaufnahme. [GPs in the Emergency Department] MMW-Fortschritte der Medizin, 2015; 157(1): 8–9. DOI: 10.1007/s15006-015-2560-1 [in German].
- Scherer M, Boczor S, Weinberg J, Kaduszkiewicz H, Mayer-Runge U, Wagner H. Allgemeinmedizin in einer Universitätsklinik –Ergebnisse eines Pilotprojekts. [General Practice in a Teaching Hospital - Results of a Pilot Project] Zeitung für Allgemeinmedizin, 2014; 90(4): 165–73. DOI: 10.3238/zfa.2014.0165-0173 [in German].
- Lauks J, Blaz M, Baumgartl K, Maier H, Nickel CH, Bingisser R. Medical Team Evaluation: Effect on Emergency Department Waiting Time and Length of Stay. Plos One, 2016. DOI: 10.1371/journal.pone.0154372
- Dickinson A, Dalal S, Beales L. Returning to contingency: the forward trauma team. Journal of The Royal Army Medical Corps, 2016; 162(6): 400–5. DOI: 10.1136/jramc-2016-000669
- Dickinson A, Roberts M, Kumar A, Weaver A, Lockey DJ. Falls From Height: Injury and Mortality. Journal of The Royal Army Medical Corps, 2012; 158(2): 123–7. DOI: 10.1136/jramc-158-02-11
- Rocks S, Bernston D, Gil-Salmerón, Kadu M, Ehrenberg N, Stein V, Tsiachristas A. Cost and effects of integrated care: a systematic literature review and meta-analysis. The European Journal of Health Economics, 2020; 21: 1211–1221. DOI: 10.1007/s10198-020-01217-5
- Christ M, Grossman F, Winter D, Bingisser R, Platz E. Modern Triage in the Emergency Department. Deutsches Aerzteblatt International, 2010 Dec; 107(50): 892–898. DOI: 10.3238/arztebl.2010.0892
- Bezzina AJ, Smith P, Cromwell D, Eagar K. Primary care patients in the emergency department: Who are they? A review of the definition of the ‘primary care patient’ in the emergency department. Emergency Medicine Australasia, 2005; 17: 472–9. DOI: 10.1111/j.1742-6723.2005.00779.x
- Valentijn PP, Schepman SM, Opheij W, Bruijnzeels MA. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. International Journal of Integrated Care, 2013; 13:
e010 . DOI: 10.5334/ijic.886 - Valentijn PP, Boesveld IC, van der Klauw DM, Ruwaard D, Struijs JN, Molema JJ, et al. Towards a taxonomy for integrated care: a mixed-methods study. International Journal of Integrated Care, 2015; 15:
e003 . DOI: 10.5334/ijic.1513 - Valentijn PP, Vrijhoef HJ, Ruwaard D, Boesveld I, Arends RY, Bruijnzeels MA. Towards an international taxonomy of integrated primary care: a Delphi consensus approach. BioMedCentral Family Practice, 2015; 16: 64. DOI: 10.1186/s12875-015-0278-x
- Hardy B, Mur-Veemanu I, Steenbergen M, Wistow G. Inter-agency services in England and TheNetherlands: A comparative study of integrated care development and delivery. Health Policy, 1999; 48: 87–105. DOI: 10.1016/S0168-8510(99)00037-8
- Bundesausschuss G. Regelungen des Gemeinsamen Bundesausschusses zu einem gestuften System von Notfallstrukturen in Krankenhäusern gemäß [Regulations of the Joint Federal Committee on a tiered system of emergency structures in hospitals] Sozialgesetzbuch, 2018; 5(136c): 4. [in German].
- Mélot C. To score or not to score during triage in the emergency department? Intensive Care Medicine, 2015; 41: 1135–1137. DOI: 10.1007/s00134-015-3814-1
- Beerheide R. POLITIK Notfallstufenkonzept: Drei Stufen für die Notfallversorgung. [Levels of Emergency Care Concept: Three levels for emergency care.] Deutsches Ärzteblatt. 2019; 116(3): 64–6. [in German].
- McCullough AL, Haycock JC, Forward DP, Moran GC. Major trauma networks in England. British Journal of Anaesthesia, 2014; 113(2): 202–6. DOI: 10.1093/bja/aeu204
- Riessen R, Gries A, Seekamp A, Dodt C, Kumle B, Busch H-J. Positionspapier für eine Reform der medizinischen Notfallversorgung in deutschen Notaufnahmen. [Postion paper for a reform of medical emergency care in German emergency departments] Notfall Rettungsmedizin, 2015; 18: 174–185. DOI: 10.1007/s10049-015-0013-0 [in German].
- Notfallversorgung: Ärzteschaft stellt Software für Triage vor [Emergency care: Doctors present software for triage]. Deutsches Aerzteblatt Online; June 2018 [Cited 2020 October 09]. Available from:
https://www.aerzteblatt.de/nachrichten/96025/Notfallversorgung-Aerzteschaft-stellt-Software-fuer-Triage-vor [in German]. - Wenger E, McDermott R, Snyder W. Seven Principles for Cultivating Communities of Practice. Harvard Business School Working Knowledge. 2002.
- Steinhauser J, Roos M, Haberer K, Ledig T, Peters-Klimm F, Szecsenyi J, et al. Bericht aus der Praxis: Das Programm Verbundweiterbildungplus des Kompetenzzentrums Allgemeinmedizin Baden-Württemberg - Entwicklung, Umsetzung und Perspektiven [Report from general practice: the composite graduate education(plus) program of the Baden-Wurttemberg General Practice Competence Center - development, implementation and prospects]. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, 2011; 105(2): 105–9. DOI: 10.1016/j.zefq.2011.02.002 [in German].
- Hibbeler B. Verbundweiterbildung Allgemeinmedizin: Strukturiert zum Ziel. [General Practice Post-graduate Training Network: A structured approach to the goal.] Deutsches Aerzteblatt, 2010; 107(30): 1436–9. [in German].
- Alberti H, Banner K, Collingwood H, Merritt K. ‘Just a GP’: a mixed method study of undermining of general practice as a career choice in the UK. BMJ Open, 2017 Nov 3; 7(11):
e018520 . DOI: 10.1136/bmjopen-2017-018520. - Rimmer A. GP bashing is unacceptable, says Health Education England. British Medical Journal, 2016; 355:
i6028 . DOI: 10.1136/bmj.i6028 - Valentijn PP, Ruwaard D, Vrijhoef HJ, de Bont A, Arends RY, Bruijnzeels MA. Collaboration processes and perceived effectiveness of integrated care projects in primary care: a longitudinal mixed-methods study. BioMed Central Health Services Research, 2015; 15: 463. DOI: 10.1186/s12913-015-1125-4
- Valentijn PP, Vrijhoef HJ, Ruwaard D, de Bont A, Arends RY, Bruijnzeels MA. Exploring the success of an integrated primary care partnership: a longitudinal study of collaboration processes. BioMed Central Health Services Research, 2015; 15: 32. DOI: 10.1186/s12913-014-0634-x
DOI: https://doi.org/10.5334/ijic.5442 | Journal eISSN: 1568-4156
Language: English
Submitted on: Oct 27, 2019
Accepted on: Jan 19, 2021
Published on: Apr 26, 2021
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
© 2021 Andrew Dickinson, Stefanie Joos, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.