Kosteneffectieviteit Primary Care Trusts bekeken

Gray JT, Walker A. Is referral to emergency care practitioners by general practitioners in-hours effective? Emerg Med J 2009 Aug;26(8):611-2

DOELSTELLING: Om de kosteneffectiviteit te evalueren in Primary Care Trusts (PCT's) van de verwijzingen van huisartsen tijdens kantoor-uren naar de spoedeisende hulp (ECP). Methodes: een retrospectieve case review van patiënten die door huisartsen verwezen zijn naar de spoedeisende hulp tijdens kantoor-urengedurende vier maanden om te kijken naar de toegevoegde waarde boven een huisartsbezoek.

OBJECTIVE: To evaluate the cost effectiveness to primary care trusts (PCT) in commissioning general practitioner (GP) referrals in-hours to emergency care practitioners (ECP). METHODS: A retrospective case note review for patients referred by GPs in-hours to ECP over a 4-month period to ascertain any added value over a GP visit. RESULTS: In a 4-month period 105 patients were referred. In most cases (90.5%) the ECP was utilised as a substitute for a GP rather than providing any additional skills. Defining an avoided attendance as the ECP undertaking an intervention outside a GP skill set this equated to a 9.5% avoided attendance rate compared with the ECP service standard rate of 60%. This has implications both in terms of financial benefit and ongoing ECP service sustainability. CONCLUSIONS: There is little value in a PCT commissioning this service as they will pay twice and care must be taken in accepting new referral streams into existing services

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