Allgemeinmedizin in einer Universitätsklinik - Ergebnisse eines pilotprojekts

Background: Family practices are the usual setting of clinical primary care. Attempts of involving a department of family practice in the clinical care of an university hospital are rare. At the University Medical Center Hamburg-Eppendorf, Germany, such a pilot project was implemented from October to December of 2012 and evaluated afterwards. Method: The clinical activity of the Department of Primary Medical Care (IfA) of the University Hospital Eppendorf Hamburg (UKE), comprises an ambulatory healthcare center (MVZ) as well as primary medical care in the emergency department (ZNA) at the UKE. The pilot project data (N = 263 from October to December 2012) were analyzed regarding the waiting times and the medical services offered, including the hospital's clinical laboratory, computer-tomography/magnetic resonance imaging and interdisciplinary consultations. This was then compared to a control group derived from a sample of ZNA cases from October of 2011 (N = 1684 cases). The satisfaction with the IfA's involvement in the hospital emergency room was evaluated using a validated patient satisfaction questionnaire (pre-post including 2 unpaired consecutive samples). Results: A total of 263 patients (162 female, 101 male) were treated by the IfA in the emergency department of the UKE. In these cases the median waiting time was 48 minutes and in less than a quarter of these, additional services such as laboratory work (20%), interdisciplinary consultations (18%) or X-rays (2%) were needed. Only 17 cases (6%) needed in-patient treatment. The mean out-patient costs were significantly lower (16,76 Euro; confidence interval (CI) 13,40-19,62 Euro) compared to a control group in the UKE emergency room in October 2011 (52,21 Euro; CI 49,16-55,26 Euro; p < 0,0001). The patient contentedness, while already good, could even be enhanced. Conclusions: The integration of a department of family practice in the every-day practice of an university hospital combining the activity in an emergency department and an ambulatory healthcare center for primary care could be a good future model.