Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study.
<h4>Background</h4>Insight in characteristics and journey of patients in the Acute Care Chain (ACC) who visit the Emergency Department (ED) is lacking. Existing studies focus on prespecified (time-sensitive) complex conditions like major trauma and stroke, and on the hospital phase. This...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0318510 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850127316906147840 |
|---|---|
| author | Lieke Claassen Patricia Maria Stassen Thimo Jozef Theresia Boumans Dennis Gerard Barten Marjolein Nel Tinie Kremers Anne Maria Elisa Hermans Noortje Zelis Jochen Wilco Lennert Cals Gideon Hubertus Petrus Latten |
| author_facet | Lieke Claassen Patricia Maria Stassen Thimo Jozef Theresia Boumans Dennis Gerard Barten Marjolein Nel Tinie Kremers Anne Maria Elisa Hermans Noortje Zelis Jochen Wilco Lennert Cals Gideon Hubertus Petrus Latten |
| author_sort | Lieke Claassen |
| collection | DOAJ |
| description | <h4>Background</h4>Insight in characteristics and journey of patients in the Acute Care Chain (ACC) who visit the Emergency Department (ED) is lacking. Existing studies focus on prespecified (time-sensitive) complex conditions like major trauma and stroke, and on the hospital phase. This study provides a representative overview of adult ED patients and their journey through the ACC with focus on differences between those with and without prespecified complex conditions.<h4>Methods</h4>A prospective 72-hour flash-mob study was conducted in 2022 across all six EDs in the province of Limburg, the Netherlands, encompassing unselected adult patients. Baseline characteristics, journey, and time within ACC were collected. Patients with a prespecified complex condition (stroke, myocardial infarction, aortic syndrome and major trauma) were compared to those without.<h4>Results</h4>Out of 794 adult ED patients, 585 (73.7%) were included. Patients reported symptoms for a median of 1 day (IQR 0-4) before their ED visit; 56.3% encountered ≥ 1 healthcare provider. General practitioners referred 56.1% of patients, and emergency medical services transported 32.9%. The median time in ACC was 5.0 hours (IQR 3.5-6.9), with 3.0 hours (IQR 2.0-4.2) spent in the ED. The three most prevalent presenting complaints were minor trauma (28.5%), abdominal pain (14.6%) and dyspnoea (12.5%), while 9.3% presented with prespecified complex conditions. Patients with a prespecified complex condition were more often triaged highly urgent (53.6% vs 13.9%, p < 0.001) and received a complex work-up (79.6% vs 41.2%, p < 0.001).<h4>Conclusion</h4>In our province-wide study, ED patients had symptoms for 1 day and over half of them already contacted a healthcare provider. Time in ACC was 5 hours, with a substantial proportion of time spent prehospitally. Prespecified complex conditions accounted for less than 1 in 10 ED patients. These findings highlight that, to optimise care and care policy, it is essential to examine the entire ACC for unselected patients.<h4>Trial registration</h4>ClinicalTrials.gov NCT06079099. |
| format | Article |
| id | doaj-art-5a58d6ca3da3443e8c26e44cd3fb2345 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-5a58d6ca3da3443e8c26e44cd3fb23452025-08-20T02:33:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01204e031851010.1371/journal.pone.0318510Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study.Lieke ClaassenPatricia Maria StassenThimo Jozef Theresia BoumansDennis Gerard BartenMarjolein Nel Tinie KremersAnne Maria Elisa HermansNoortje ZelisJochen Wilco Lennert CalsGideon Hubertus Petrus Latten<h4>Background</h4>Insight in characteristics and journey of patients in the Acute Care Chain (ACC) who visit the Emergency Department (ED) is lacking. Existing studies focus on prespecified (time-sensitive) complex conditions like major trauma and stroke, and on the hospital phase. This study provides a representative overview of adult ED patients and their journey through the ACC with focus on differences between those with and without prespecified complex conditions.<h4>Methods</h4>A prospective 72-hour flash-mob study was conducted in 2022 across all six EDs in the province of Limburg, the Netherlands, encompassing unselected adult patients. Baseline characteristics, journey, and time within ACC were collected. Patients with a prespecified complex condition (stroke, myocardial infarction, aortic syndrome and major trauma) were compared to those without.<h4>Results</h4>Out of 794 adult ED patients, 585 (73.7%) were included. Patients reported symptoms for a median of 1 day (IQR 0-4) before their ED visit; 56.3% encountered ≥ 1 healthcare provider. General practitioners referred 56.1% of patients, and emergency medical services transported 32.9%. The median time in ACC was 5.0 hours (IQR 3.5-6.9), with 3.0 hours (IQR 2.0-4.2) spent in the ED. The three most prevalent presenting complaints were minor trauma (28.5%), abdominal pain (14.6%) and dyspnoea (12.5%), while 9.3% presented with prespecified complex conditions. Patients with a prespecified complex condition were more often triaged highly urgent (53.6% vs 13.9%, p < 0.001) and received a complex work-up (79.6% vs 41.2%, p < 0.001).<h4>Conclusion</h4>In our province-wide study, ED patients had symptoms for 1 day and over half of them already contacted a healthcare provider. Time in ACC was 5 hours, with a substantial proportion of time spent prehospitally. Prespecified complex conditions accounted for less than 1 in 10 ED patients. These findings highlight that, to optimise care and care policy, it is essential to examine the entire ACC for unselected patients.<h4>Trial registration</h4>ClinicalTrials.gov NCT06079099.https://doi.org/10.1371/journal.pone.0318510 |
| spellingShingle | Lieke Claassen Patricia Maria Stassen Thimo Jozef Theresia Boumans Dennis Gerard Barten Marjolein Nel Tinie Kremers Anne Maria Elisa Hermans Noortje Zelis Jochen Wilco Lennert Cals Gideon Hubertus Petrus Latten Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study. PLoS ONE |
| title | Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study. |
| title_full | Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study. |
| title_fullStr | Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study. |
| title_full_unstemmed | Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study. |
| title_short | Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study. |
| title_sort | characteristics of dutch ed patients and their journey through the acute care chain a province wide flash mob study |
| url | https://doi.org/10.1371/journal.pone.0318510 |
| work_keys_str_mv | AT liekeclaassen characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT patriciamariastassen characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT thimojozeftheresiaboumans characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT dennisgerardbarten characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT marjoleinneltiniekremers characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT annemariaelisahermans characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT noortjezelis characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT jochenwilcolennertcals characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy AT gideonhubertuspetruslatten characteristicsofdutchedpatientsandtheirjourneythroughtheacutecarechainaprovincewideflashmobstudy |