PubMed · 9972402
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K M Hillman. 1998. Redefining resuscitation.. https://doi.org/10.1111/j.1445-5994.1998.tb01549.x
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OBJECTIVES: To quantify the impact of NHS Direct on the use of accident and emergency, ambulance, and general practitioner cooperative services. DESIGN: Observational study of trends in use of NHS Direct and other immediate care services over 24 months spanning introduction of NHS Direct. SETTING: Three areas in England in first wave of introduction of NHS Direct, and six nearby general practitioner cooperatives as controls. SUBJECTS: All contacts with these immediate care services. MAIN OUTCOME MEASURES: Changes in trends in use after introduction of NHS Direct. RESULTS: NHS Direct received about 68 500 calls from a population of 1.3 million in its first year of operation, of which 72% were out of hours and 22% about a child aged under 5 years. Changes in trends in use of accident and emergency departments and ambulance services after introduction of NHS Direct were small and non-significant. Changes in trends in use of general practitioner cooperatives were also small but significant, from an increase of 2.0% a month before introduction of NHS Direct to -0.8% afterwards (relative change -2. 9% (95% confidence interval -4.2% to -1.5%)). This reduction in trend was significant both for calls handled by telephone advice alone and for those resulting in direct contact with a doctor. In contrast, the six control cooperatives showed no evidence of change in trend; an increase of 0.8% a month before NHS Direct and 0.9% after (relative change 0.1% (-0.9% to 1.1%)). CONCLUSION: In its first year NHS Direct did not reduce the pressure on NHS immediate care services, although it may have restrained increasing demand on one important part-general practitioners' out of hours services.
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OBJECTIVE: To study the frequency and characteristics of the hospitalized patients medical emergencies. PATIENTS AND METHODS: We have collected daily the notice to the emergency room from patients hospitalized and we have analyzed the clinical and epidemiological characteristics. RESULTS: Three hundred forty-one notices were recorded. The daily mean was higher on holidays. There were mostly medical problems (78%). Complementary explorations were performed in the 44% of the patients, and in the 77% the treatment was changed. CONCLUSIONS: The in-patient emergencies account for an important charge of work for the emergency team and involve important diagnosis and therapeutic decisions.