Zwischen Vision und Wirklichkeit: Untersuchung zur Machbarkeit der Weiterleitung von weniger dringlichen Hilfesuchenden in die ambulante Versorgung

We investigated both feasibility and acceptance of redirecting patients who presented with low acuity in an emergency department (ED) to cooperating physician practices.

During practice opening hours at the ED of RoMed Hospital Rosenheim self-referring patients, classified as green and blue based on Manchester Triage System, were offered an extended assessment based on Structured medical Assessment (SmED) to determine, if they could be redirected to a cooperating practice (cp). Patients with a recommendation for ambulatory treatment were digitally registered in a cp via IVENA eHealth for a same-day appointment. Triage staff at the hospital and the cooperation physicians were asked to respond to an online questionnaire on feasibility and acceptance. A descriptive data analysis was performed.

Between April and July 2023, 193 patients were included in the study. The median age was 43.5 years; 45.1% of patients were male. Based on the extended assessment, 88.6% (95% confidence interval [CI] 84.1–93.1), patients were offered an appointment in a cp; 15.2% (95% CI 9.8–20.6) of these patients declined and for 17% (95% CI 11.4–22.6) no appropriate appointment was available. Overall, 60.1% of the study participants were redirected to a cp and 56% received concluding treatment. In all, 6.9% (95% CI 2.3–11.5) of referred patients returned to the ED. Participants were satisfied with the IVENA eHealth application and reported high acceptance by patients.

Redirection of less urgent patients is feasible and safe under day-to-day conditions. Thus, the feasibility study represents a potential application according to 120 (3b) SGB V.