Referral of non-urgent cases from an emergency department

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Abstract
A phenomenon of great concern in several Western countries is the number of patients with non-urgent ailments attending the often overloaded hospital emergency departments (EDs). With a view to providing these patients with more appropriate care, they were, in a trial at Huddinge Hospital, Sweden, advised and directed to other care facilities by a specially trained nurse. A survey indicated that 84% of the patients who agreed to a referral followed the advice given. Referred patients were satisfied with the specific service at the ED to the same extent as were control patients receiving care according to the usual routines of the ED. Moreover, the former were more likely to have a positive general attitude towards the ED. There was a positive relationship between improvement of presenting symptom and satisfaction with care at the ED, and between satisfaction and favourable attitude towards the ED. However, although patients were willing to engage in a primary health care oriented behaviour, they did not report improvement to the same extent as did ED treated patients and their general attitude towards primary health care facilities was not more favourable, at least not within a few weeks after referral.