Primary care access to radiology: Characteristics of trauma patients referred to the emergency department

• Published in: Journal of evaluation in clinical practice Vol. 29; no. 1; pp. 101 - 107
• Main Authors: Kusters, Renske W. J., Peters, Nathalie A. L. R., Osch, Frits H. M., Simons, Petra C. G., Hulsbosch, Mark H. H. M., Janzing, Heinrich M. J., Barten, Dennis G.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.02.2023; John Wiley and Sons Inc
• Subjects: access to care; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Emergency Department; Emergency medical care; Emergency Service, Hospital; Family physicians; Health care access; Humans; Infant; Injuries; Length of Stay; Middle Aged; Original Paper; Original Papers; Primary care; Primary Health Care; Radiography; Radiology; Retrospective Studies; Trauma; Young Adult; Netherlands; trauma; primary health care; access to care; Emergency Department; radiology
• ISSN: 1356-1294; 1365-2753
• DOI: 10.1111/jep.13738

Rationale, Aims and Objectives Low‐urgent Emergency Department (ED) attendances are a known contributing factor to ED crowding. In the Netherlands, general practitioners (GPs) have direct access to radiology facilities during office hours. Patients with radiographically confirmed traumatic injuries are subsequently referred to the ED. We analysed these ED trauma patients' characteristics, provided treatments and ED discharge diagnoses to identify the possibility of alternative care pathways. Methods Single‐centre retrospective observational study of trauma patients referred to the ED by the radiology department during office hours (January 2017–December 2017). Data were obtained from patient records. Descriptive statistics were used to analyse the extracted data. Results A total of 662 patients were included. The median age was 42 years (range: 1–100, interquartile range (IQR): 15–63) and patients presented to the ED with a median delay of 1 day (range: 0–112 days, IQR: 0–5). Most patients were referred for injuries involving the upper extremities (61.5%) and lower extremities (30%). A total of 48 additional diagnoses were made in the ED. The majority of injuries was classified as ‘minor’ (29.5%) or ‘moderate’ (68.3%) on the Abbreviated Injury Scale (AIS). The median length of stay in the ED was 65 min (range: 7–297 min, IQR: 43–102). Conclusion Most patients presented with low acuity injuries and often with a notable delay to the ED. This suggests that the majority of these patients do not necessarily need ED treatment, which may provide an opportunity to counter ED crowding.