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Organisation and Payment of Emergency Care Services in Selected Countries

Quentin W, Baier N, Bech M, Bernstein D, Cowling T, Jackson T, van Manen J, Rudkjobing A, Geissler A
erschienen in:
KCE Report 263 pp. 165 - 203




In Belgium and in most high-income countries, the number of visits to hospital emergency departments (EDs) has increased considerably over recent years. The reasons for this increase are multifaceted and include factors related to both patient characteristics (e.g. demographic change, socioeconomic conditions, lack of knowledge about different options for emergency care, or changing preferences) and service characteristics (e.g. lack of access to primary care services, inconvenient primary care out-of hours services, complexity of the care system for unscheduled urgent and emergency care).

In many countries, the high number of patients at EDs has led to increasing workload for providers, long waiting times for patients, reduced quality of care, and inefficient use of resources. In addition, a considerable proportion of patients at EDs have been found to attend for conditions that do not require urgent attention or complex interventions – and could potentially be managed by primary care providers in a timelier manner and at lower costs. In fact, these visits to EDs are often referred to as inappropriate’ ED visits, although there is considerable debate about the concept of inappropriateness’.

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