Back to Search
Start Over
Reorganizing territorial healthcare to avoid inappropriate ED visits: does the spread of Community Health Centres make Walk-in-Clinics redundant?
- Source :
- BMC Health Services Research, BMC Health Services Research, Vol 20, Iss 1, Pp 1-11 (2020)
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Background Community care has recently been restructured with the development of Community Health Centres (CHCs), forcing a general rethink on the survival of previous organizational solutions adopted to reduce inappropriate ED access, for example Walk-in-Clinics (WiCs). Methods We focus on the Italian Emilia-Romagna Region that has made huge investments in CHC development, whilst failing to proceed at a uniform rate from area to area. Estimating panel count data models for the period 2015–2018, we pursue two goals. First we test the existence of a “CHC effect”, choosing five urban cities with different degree of development of the CHC model and assessing whether, all else being equal, patients treated by GPs who have their premises inside the CHC show a lower need to seek inappropriate care (Aim 1). Second, we focus our attention on Walk-in-Clinics, investigating the long-established WiC in the city of Parma that currently coexists with three CHCs recently established in the same catchment area. In this case we try to assess whether, and to what extent, the progressive development of the CHCs in the city of Parma has been affecting the dynamics of WiC access (Aim 2). Results As regards Aim 1, we show that CHCs reduce the probability of inappropriate patient access to emergency care. As regards Aim 2, in the city of Parma patients whose GP belongs to the CHC are less likely to visit the WiC on a workday, with no significant change during the weekend when CHCs are closed, questioning the need to maintain them both in the same area when the CHC model is fully implemented. Conclusions Our results confirm the hypothesis that expanding access to primary care settings diminishes inappropriate ED use. In addition, our findings suggest that where CHCs and WiCs coexist in the same area, it may be advisable to implement strategies that bring WiC activities into step with CHC-based general primary care reforms to avoid duplication.
- Subjects :
- Adult
Male
medicine.medical_specialty
Community Health Centre
Ambulatory Care Facilities
Health informatics
Health Services Accessibility
Health administration
03 medical and health sciences
0302 clinical medicine
Nursing
Inappropriate ED use
Health care
Walk-in-Clinics
medicine
Humans
Community Health Services
030212 general & internal medicine
I10
Aged
Aged, 80 and over
I18
Primary Health Care
Community Health Centres
business.industry
Walk-in
lcsh:Public aspects of medicine
030503 health policy & services
Health Policy
Nursing research
Public health
lcsh:RA1-1270
Community Health Centers
Middle Aged
Primary care
H5
Italy
Community health
Female
Catchment area
Emergency Service, Hospital
0305 other medical science
business
C21
Delivery of Health Care
Research Article
Subjects
Details
- ISSN :
- 14726963
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....dceffbfca428c19899ca2230b8e48df8