An instrument as an action against the blind spot of acute medical care in general practice - a systematic review

Background: Increasing visits to out-of-hours practices and Emergency Departments (EDs) for non-life-threatening urgent cases (NLTUCs) have placed a significant burden on healthcare systems worldwide. General practitioners (GPs), as the first point of contact in primary care, play a critical role in managing acute medical cases. However, limited research has focused on their contribution to acute care, and tools for assessing these cases remain non-existent. Aim: This review aimed to identify instruments for detecting acute medical cases in GP practices, addressing the gap in tools and frameworks specific to the primary care setting. Methods: A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, CINAHL, Scopus, and Web of Science, focusing on studies describing instruments for acute care assessment in primary care. Results: Of 1,560 identified studies, one met the inclusion criteria. The included study described a coding tool designed to assess the complexity of GP consultations, using the ICPC-2 classification system. While this tool effectively captures the multifaceted nature of GP encounters, it was not specifically designed to measure urgency in acute care. Discussion: The review highlights a significant gap in tools for assessing urgency in GP practices, contrasting with established hospital triage systems. Adapting existing tools to incorporate urgency assessment could illuminate the critical impact of GPs on reducing ED burden and managing acute cases. Conclusion: The identified tool for assessing consultation complexity could be adapted to evaluate urgency, highlighting the critical yet underrecognized role of GPs in acute care.