How Do Patients Referred to the Emergency Department by a Medical Practitioner Differ from Self-Referred Patients?

Introduction: Few studies have evaluated the cha-racteristics of patients referred to Emergency Departments (ED) by a medical practitioner and those of patients atten-ding EDs of their own initiative. This study aimed to com-pare these two populations as defined by their means of referral. Materials and methods: A transversal retrospective study was performed in the Occitanie region EDs from 2016 to 2018. The analysis concerned data from ED visit reports. Two patients groups were created: those attending following a medical referral and those non-referred, attending directly. Results: Of the 1,812,795 attendance, 80% attended on their own initiative. Of the 20% of patients referred, 75% were referred by the emergency services (Samu) and 25% by a private medical practitioner. Referred patients were older than non-referred patients (average age: 57 +/- 26 versus 36 +/- 24 years). Referred patients were, in 71% of cases, direc-ted to public EDs, and in 76% of cases, arrived by medical transportation. The median duration of ED attendance was greater in the referred patient group (4 h 23 min as opposed to 2 h 25 min for the non-referred group). Referred patients were more severely ill (3% CCMU4-5 versus 0.4% in the non-referred group) and more often hospitalized (38 versus 12% in the non-referred group). Motives for consultation were, however, quite similar in the two groups. Conclusion: Those patients referred to EDs were very diffe-rent from those attending on their own initiative.