Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Rationale, aims and objectives</jats:title><jats:p>The inappropriate use and overcrowding of emergency departments (<jats:styled-content style="fixed-case">EDs</jats:styled-content>) by walk‐in patients are well‐known problems in many countries. The current study aimed to determine whether ambulatory walk‐in patients could be treated more efficiently in a new hospital‐integrated general practice (<jats:styled-content style="fixed-case">HGP</jats:styled-content>) for emergency care services compared to a traditional <jats:styled-content style="fixed-case">ED</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a pre‐post comparison before and after the implementation of a new <jats:styled-content style="fixed-case">HGP</jats:styled-content>. Participants were walk‐in patients attending the <jats:styled-content style="fixed-case">ED</jats:styled-content> of a city hospital in <jats:styled-content style="fixed-case">Z</jats:styled-content>urich. Main outcome measures were differences in total process time, time intervals between stages of care and diagnostic resources used.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The median process time from admission to discharge was 120 minutes in the <jats:styled-content style="fixed-case">ED</jats:styled-content> [interquartile range (<jats:styled-content style="fixed-case">IQR)</jats:styled-content>: 80–165] versus 60 minutes in the <jats:styled-content style="fixed-case">HGP</jats:styled-content> (<jats:styled-content style="fixed-case">IQR</jats:styled-content>: 40–90) (<jats:italic>P</jats:italic> < 0.001). The adjusted odds ratio of receiving any additional diagnostics was 1.86 (95% confidence interval 1.06–3.27; <jats:italic>P</jats:italic> = 0.032) for <jats:styled-content style="fixed-case">ED</jats:styled-content> doctors versus general practitioners (<jats:styled-content style="fixed-case">GPs</jats:styled-content>) when controlling for patients' age, sex and injury‐related medical problems.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The <jats:styled-content style="fixed-case">HGP</jats:styled-content> is an efficient way to manage walk‐in patients with regard to process time and utilization of additional diagnostic resources. The involvement of <jats:styled-content style="fixed-case">GPs</jats:styled-content> in the <jats:styled-content style="fixed-case">HGPs</jats:styled-content> should be considered as a promising model to overcome the inappropriate use of resources in <jats:styled-content style="fixed-case">EDs</jats:styled-content> for walk‐in patients who can be treated by ambulatory care.</jats:p></jats:sec>