Clinical benefits and risks of emergency departments with or without co-located primary care-driven urgent care centers: A systematic review

Resumo original em inglês

O que aconteceu

A significant proportion of patients who visit the emergency department (ED) could be treated at a lower level of care. Urgent Care Center (UCC) are described as a promising remedy for ED crowding.

The question addressed in this systematic review was: For patients visiting an ED, what are the benefits and risks of EDs with the ability to triage patients to an UCC versus EDs without that capability?

This systematic review was conducted as part of a health technology assessment (HTA) performed at an HTA-center. The literature search was limited to studies with a control group; both randomized controlled studies and non-randomized controlled studies (including before and after studies) published from the year 2000 onward, in English, Swedish, Danish, or Norwegian were eligible. The outcomes of interest included mortality, serious adverse events, and length of stay (LOS).

O que encontraram

No data are available regarding the outcomes deemed critical for decision, mortality and serious adverse events. This systematic review had the ambition to describe the scientific evidence for a specific model of UCCs with a shared triage in the ED. A diversity of interventions, comparators and outcomes in previous studies gives the issue a complexity that is hard to overcome. Based on one retrospective study corresponding to the strict definition of intervention, comparator and outcomes it is uncertain whether EDs with UCCs differ from EDs without UCCs in terms of LOS for patients visiting the ED. From a health economics perspective, there is no data on the cost-effectiveness of UCCs. Thus, this review identified evidence gaps regarding the specific model considered. For all stakeholders and decision-makers in government-funded healthcare systems, it is important to allocate funds where they will be most effective.

Por que isso importa

The benefits and risks of EDs that can triage patients to an Urgent Care Center (UCC) compared to EDs without this possibility remain uncertain. We advocate for evidence-based decision-making in emergency care management and conclude that further prospective studies are needed to address this question.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.