General practice in the emergency department-Which patients? Which complaints?

Background Because increasing numbers of patients remain in outpatient care after visiting the emergency department (ED), general practitioners have been integrated into the ED of a university hospital. Within the ED, patients who present with general medical complaints and show low urgency for treatment in the initial assessment are assigned to the general practitioner. The aim of this study was to characterize these patients with regard to their health complaints that led to their presentation in the ED. Methods Descriptive analysis based on routine data and a self-developed evaluation form. Results About 80% of the patients visited the ED without a physician's referral. The five most frequent reasons for consultation were abdominal pain, back pain, chest pain, pain in the lower extremities and nausea and/or vomiting. In almost 25% of the patients, the complaints started on the day of the presentation, in about 33% the health complaints had existed for more than a week. Half of the patients had already received outpatient medical treatment for their complaints; in the group of patients with complaints lasting longer than one week, this proportion was more than 80%. Patients with fever or impaired general state of health were admitted to hospital most frequently. Of the self-referrals, almost 94% could be discharged to outpatient care. Conclusion Patients visit the ED with nonacute complaints and despite previous outpatient treatment. The most frequent reasons for consultation of patients treated by general practitioners in the ED only partially overlap those of patients treated by general practitioners in regular outpatient care.