Comparing Performance Outcomes of Emergency Medicine-Trained vs. Non-Emergency Medicine-Trained Physicians in Emergency Departments.

BACKGROUND

Non-emergency medicine (EM)-trained physicians comprise a notable proportion of the emergency medicine workforce in Taiwan and many other countries. The possible performance differences at the emergency department (ED) between EM-trained and non-EM-trained physicians have not been evaluated before.

METHODS

This retrospective observational study was conducted between August 2018 and July 2020 at a regional hospital in Taiwan. We compared the two physician groups for quality-of-care outcomes, including waiting time, rate of failing to visit patients within the required time, length of ED stay, admission rate, intensive care unit admission rate, unscheduled return visit, return of spontaneous circulation rate in out-of-hospital cardiac arrest patients, in-hospital cardiac arrest incidence, referral rate, and computed tomography (CT) scan utilization.

RESULTS

A total of 37,013 ED visits were included. When compared to the non-EM-trained physicians, patients managed by the seven EM-trained physicians had shorter waiting time (6.1 min vs. 9.2 min, < 0.001), shorter ED stay (146.5 min vs. 176.1 min, < 0.001), lower rate of failing to visit patients within the required time (0.8% vs. 1.1%, = 0.010), lower unscheduled return visit rate (4.9% vs. 5.4%, = 0.043), and lower CT scan utilization (0.16 [times/patient/visit] vs. 0.18 [times/patient/visit], < 0.001).

CONCLUSION

The EM-trained and non-EM-trained physicians' performance at a regional hospital ED differed. Our findings could be used as a reference for healthcare policy-makers and hospital management.