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Addressing the overuse of hospital emergency departments in the Portuguese NHS

2024-12Artigo científico Acesso aberto
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dc.contributor.authorGoiana-da-Silva, Francisco
dc.contributor.authorCosta, Soraia
dc.contributor.authorMalcata, Filipa
dc.contributor.authorSá, Juliana
dc.contributor.authorVasconcelos, Rafael
dc.contributor.authorCabral, Miguel
dc.contributor.authorGuedes, Raisa
dc.contributor.authorMorais-Vilaça, Inês
dc.contributor.authorPinheiro-Guedes, Lara
dc.contributor.authorFerreira, João
dc.contributor.authorPereira, Nélson
dc.contributor.authorGaspar-Pais, José
dc.contributor.authorNeves, Judite
dc.contributor.authorMonteiro, Joaquim
dc.contributor.authorPires, Vera
dc.contributor.authorPaiva, Miguel
dc.contributor.authorGuimarães, Rui
dc.contributor.authorAshrafian, Hutan
dc.contributor.authorMoreira, Rita
dc.contributor.authorFonseca, Fátima
dc.contributor.authorCardoso, Filomena
dc.contributor.authorAlves, Jaime
dc.contributor.authorDarzi, Ara
dc.contributor.authorAraújo, Fernando
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblFrontiers Media
dc.date.accessioned2025-02-10T21:19:50Z
dc.date.available2025-02-10T21:19:50Z
dc.date.issued2024-12
dc.descriptionPublisher Copyright: Copyright © 2025 Goiana-da-Silva, Costa, Malcata, Sá, Vasconcelos, Cabral, Guedes, Morais-Vilaça, Pinheiro-Guedes, Ferreira, Pereira, Gaspar-Pais, Neves, Monteiro, Pires, Paiva, Guimarães, Ashrafian, Moreira, Fonseca, Cardoso, Alves, Darzi and Araújo.
dc.description.abstractThe escalating trend of inappropriate visits to Emergency Departments (ED) has led to significant concerns, including resource misallocation, compromised patient care, and an increased burden on healthcare workers. Portugal faces a notable challenge, reporting one of the highest per capita ED visit rates, with an annual average of approximately 6 million ED visits from 2013 to 2023. In response, the “Call First, Save Lives” pilot project was launched by the Portuguese NHS Executive Board, in 2023, at the Local Health Unit (LHU) of Póvoa de Varzim/Vila do Conde. This project leverages the SNS 24 telephone triage system to direct patients to the most appropriate care settings, alleviating pressure on ED, and optimizing healthcare resources. The project introduced several strategic enhancements, including optimizations of the SNS 24 system and inter-institutional initiatives to promote interoperability, hospital follow-ups for chronic conditions, and a “reverse referral” system directing non-urgent ED cases to Primary Care Services (PCS). In PCS, the project expanded acute care consultations and introduced complementary health services. The initiative also emphasized communication to improve health literacy and appropriate utilization of the NHS, supported by legal framework development. Since the beginning of the project, the number of calls received by SNS 24 showed an upward trend, both at the local, 27.6%, and national level, 44.5%, having already expanded to other LHU. Nonetheless, challenges such as the “reverse referral” process complexity, healthcare information systems integration, and procedural standardization need addressing, with future plans including satisfaction surveys and patient triage protocol refinements to improve service delivery and patient adherence.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent344111
dc.identifier.doi10.3389/fpubh.2024.1444951
dc.identifier.issn2296-2565
dc.identifier.otherPURE: 109184754
dc.identifier.otherPURE UUID: 5b326603-a742-4a86-bff6-dac25f544aaf
dc.identifier.otherScopus: 85216272124
dc.identifier.otherPubMed: 39872099
dc.identifier.urihttp://hdl.handle.net/10362/178778
dc.identifier.urlhttps://www.scopus.com/pages/publications/85216272124
dc.language.isoeng
dc.peerreviewedyes
dc.subjectcare integration
dc.subjectemergency department
dc.subjecthealthcare optimization
dc.subjectprimary healthcare
dc.subjecttriage
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectSDG 3 - Good Health and Well-being
dc.titleAddressing the overuse of hospital emergency departments in the Portuguese NHSen
dc.title.subtitlea new paradigmen
dc.typejournal article
degois.publication.titleFrontiers in public health
degois.publication.volume12
dspace.entity.typePublication
rcaap.rightsopenAccess

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