Acute primary care in the Netherlands

The collaboration between general practitioner cooperatives and emergency departments

Martijn Rutten

M Rutten titelpagina

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This thesis demonstrates that a more efficient and cost-effective organisation of out-of hours
primary emergency care can be realised by increased collaboration between GPC
and ED at an ECAP. The redirection of self-referrals from ED to GPC has proven to be safe,
efficient and cost-effective. GPC access to hospital radiology facilities is beneficial for
patients and professionals and the diagnostics are used adequately.
Therefore, we recommend that all EDs in the Netherlands cooperate with a GPC in an
ECAP. This will provide the opportunity to redirect more self-referrals nationwide from the
ED to primary care facilities. Furthermore, it offers possibilities to provide GPCs access to
hospital radiology. Due to this increased nationwide collaboration, unnecessary referrals
and specialist care will be prevented, which will result in a decrease in ED attendance and
healthcare costs.
Although the ECAP has proven positive effects, it will probably not be sufficient to cope
with the arising problems in emergency care (increased workload, shortages in capacity
and personnel). The ECAP might offer a foundation for further collaboration between
emergency care providers in the Netherlands. This could be realised by the reorganisation
of emergency care into Mutual Medical Emergency Services (MMES). All emergency care
providers participate in the MMES, sharing expertise, facilities and capacity, with the aim
to create a more efficient, economical, sustainable and patient centred emergency care
system in the Netherlands.

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