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Spoedzorg in de huisartsenpraktijk.

Maas, J. van der, Rutten, M., Smits, M., Boven, K. van, Giesen, P. Spoedzorg in de huisartsenpraktijk. Huisarts en Wetenschap: 2018, 61(2), p. 36-43.
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Background
General practitioners are responsible for providing emergency care, be it at an out-of-hours service or in their own practice; however, it is not known how many practice visits are for emergency care.

Aim
We investigated the frequency of emergency care visits, for which patients, and the care provided. We also investigated the number of patients who went to an accident and emergency (A&E) department, without GP referral, during office hours.

Method
In this retrospective, transverse study, we analysed all patient contacts in seven general practices spread throughout the Netherlands in week 42 in 2016. The type of patient and care provided were assessed for patients requiring emergency care. The number of letters received from A&E departments was also counted.

Results
Of 2520 patient contacts, 108 (4.3%) were for emergency care. Of these, 74% occurred during a practice visit and 23% during a home visit. Respiratory disorders were the most common problem (29%). In 23% of the cases additional investigations were ordered, in 48% medicine was prescribed; in only 1% was emergency medication required. Overall, in 18% of cases the patient was referred to hospital. Thirteen patients visited an A&E department on their own initiative or after phoning 112; 3 came by ambulance and 2 did not require specialist care.

Conclusion
Although emergency care contacts accounted for only 4–5% of all patient contacts in general practice, with 2.9 million of such contacts annually general practice provides a substantial amount of emergency care in the Netherlands. Relatively few people go to an A&E department on their own initiative during office hours. (aut. ref.)