Rieken Johannes, Hötker Daniel, Strumann Christoph, Steinhäuser Jost
Institute of Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Bundeswehrkrankenhaus, Hamburg, Germany.
BMC Prim Care. 2025 Mar 8;26(1):67. doi: 10.1186/s12875-025-02749-6.
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.
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.
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.
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.
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.
The identified tool for assessing consultation complexity could be adapted to evaluate urgency, highlighting the critical yet underrecognized role of GPs in acute care.
因非危及生命的紧急病例（NLTUCs）而增加的非工作时间就诊以及急诊部门（EDs）的就诊量给全球医疗系统带来了沉重负担。全科医生（GPs）作为初级医疗保健的第一接触点，在管理急性医疗病例方面发挥着关键作用。然而，针对他们对急性护理贡献的研究有限，且评估这些病例的工具仍然不存在。
本综述旨在识别用于在全科医生诊所检测急性医疗病例的工具，填补初级医疗保健环境中特定工具和框架的空白。
按照PRISMA指南进行系统综述。在PubMed、CINAHL、Scopus和科学网中进行检索，重点关注描述初级医疗保健中急性护理评估工具的研究。
在1560项已识别的研究中，有一项符合纳入标准。纳入的研究描述了一种编码工具，该工具使用ICPC - 2分类系统来评估全科医生会诊的复杂性。虽然该工具有效地捕捉了全科医生会诊的多方面性质，但它并非专门设计用于测量急性护理中的紧迫性。
该综述凸显了全科医生诊所中评估紧迫性工具的重大空白，这与成熟的医院分诊系统形成对比。调整现有工具以纳入紧迫性评估可能会阐明全科医生对减轻急诊负担和管理急性病例的关键影响。
所识别的用于评估会诊复杂性的工具可进行调整以评估紧迫性，凸显了全科医生在急性护理中关键但未得到充分认识的作用。
