Silvia Caristia, Isabella Santomauro, Erika Bassi, Laura Ferraris, Alberto Dal Molin, Fabrizio Faggiano
The evaluation shows that the agreement can facilitate cross-sectoral communication, in some cases may improve treatment quality and safety and may support safer transitions from hospital to municipal care. The agreement does not reduce readmissions among the target group in general; however, it might facilitate avoidance of unnecessary readmissions in cases where cross-sectoral dialogue is sufficient.
BACKGROUND: Emergency departments (EDs) are experiencing a growing burden of non-urgent presentations, which frequently signal deficiencies in access to primary and community-based healthcare. Evidence suggests that a substantial proportion of ED visits could be safely and effectively managed within community care settings. The general aim of the study was to identify which ED visits could have been managed within primary and community care services in a scenario of full implementation of community health centers.
METHODS: A retrospective observational study was conducted. This study examined data from the first-level ED at S.S. Trinità Hospital, Borgomanero in Northern Italy. It involved analyzing all access data from the ED in 2022. Avoidable ED visits were identified using triage assessments, multidisciplinary team, double-blinding nursing assessments, and data validation.
RESULTS: Of the 43,437 ED visits in 2022, 91.8% were nonurgent (n = 39,864). We identified 46.3% (n = 20,104) of the ED visits as avoidable, with the most common characteristics of presentation being trauma or burns, fever, eye issues, urological symptoms, ear nose and throat problems, lower back pain, and swelling.
CONCLUSIONS: Our findings highlight the need to strengthen primary care services through cohesive, accessible, and timely interprofessional networks to effectively address non-urgent healthcare needs and reduce the burden on ED settings.