Johannes Rieken, Daniel Hötker, Christoph Strumann, Jost Steinhäuser
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引用次数: 0
Abstract
Background: Increasing visits to out-of-hours practices and Emergency Departments (EDs) for non-life-threatening urgent cases (NLTUCs) have placed a significant burden on healthcare systems worldwide. General practitioners (GPs), as the first point of contact in primary care, play a critical role in managing acute medical cases. However, limited research has focused on their contribution to acute care, and tools for assessing these cases remain non-existent.
Aim: This review aimed to identify instruments for detecting acute medical cases in GP practices, addressing the gap in tools and frameworks specific to the primary care setting.
Methods: A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, CINAHL, Scopus, and Web of Science, focusing on studies describing instruments for acute care assessment in primary care.
Results: Of 1,560 identified studies, one met the inclusion criteria. The included study described a coding tool designed to assess the complexity of GP consultations, using the ICPC-2 classification system. While this tool effectively captures the multifaceted nature of GP encounters, it was not specifically designed to measure urgency in acute care.
Discussion: The review highlights a significant gap in tools for assessing urgency in GP practices, contrasting with established hospital triage systems. Adapting existing tools to incorporate urgency assessment could illuminate the critical impact of GPs on reducing ED burden and managing acute cases.
Conclusion: The identified tool for assessing consultation complexity could be adapted to evaluate urgency, highlighting the critical yet underrecognized role of GPs in acute care.
背景：越来越多的非工作时间就诊和急诊部门（EDs）的非危及生命的紧急情况（NLTUCs）已经给世界各地的医疗保健系统带来了巨大的负担。全科医生（全科医生）作为初级保健的第一接触点，在管理急性医疗病例中发挥着关键作用。然而，有限的研究集中在他们对急性护理的贡献上，评估这些病例的工具仍然不存在。目的：本综述旨在确定在全科医生实践中检测急性医疗病例的工具，解决初级保健环境中特定工具和框架的差距。方法：按照PRISMA指南进行系统评价。在PubMed、CINAHL、Scopus和Web of Science中进行检索，重点关注描述初级保健急性护理评估工具的研究。结果：在1560项确定的研究中，1项符合纳入标准。纳入的研究描述了一个编码工具，旨在评估全科医生咨询的复杂性，使用ICPC-2分类系统。虽然这个工具有效地捕捉了全科医生接触的多面性，但它并不是专门设计来衡量急症护理的紧迫性。讨论：回顾强调了在评估紧急情况的工具在全科医生的做法，与建立医院分诊系统的显著差距。调整现有工具以纳入紧急评估可以阐明全科医生在减轻急诊科负担和管理急性病例方面的关键影响。结论：确定的评估咨询复杂性的工具可以用于评估紧迫性，突出了全科医生在急性护理中的重要作用，但尚未得到充分认识。
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