This study, conducted in a Finnish city, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hours primary care would modify service usage for specific gender, age or diagnosis groups. This was an observational retrospective study carried out by gradually decreasing ED services in primary care. The interventions aimed at decreasing use of EDs were a) application of ABCDE-triage combined with public guidance on the proper use of EDs, b) closure of a minor supplementary ED, and finally, c) application of “reverse triage” with enhanced direction of the public to office-hours services and away from the remaining ED The annual number of visits to office-hours primary care GPs in different gender, age and diagnosis groups (International Classification of Diseases (ICD − 10) were recorded during a 13-year follow-up period. The total number of monthly visits to EDs decreased slowly over the whole study period. This decrease was similar in women and men. The decrease was stronger in the youngest age groups (0–19 years). GPs treated decreasing proportions of ICD-10 groups. Recorded infectious diseases (Groups A and J, and especially diagnoses related to infections of respiratory airways) tended to decrease. However, visits due to injuries and symptomatic diagnoses increased. Decreasing services in a primary health care ED with the described interventions seemed to reduce the use of services by young people. The three interventions mentioned above had the effect of making the primary care ED under study appear to function more like a standard ED driven by specialized health care.

中文翻译：

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在旨在减少过度拥挤的干预措施后发展初级卫生保健急诊部门的使用：一项纵向随访研究

这项在芬兰城市进行的研究检查了在过度拥挤的初级保健 ED 中减少急诊科 (ED) 服务以及相应的办公时间初级保健方向是否会改变特定性别、年龄或诊断组的服务使用情况。这是一项观察性回顾性研究，通过逐渐减少初级保健中的 ED 服务进行。旨在减少 ED 使用的干预措施是 a) 应用 ABCDE 分流与正确使用 ED 的公共指导相结合，b) 关闭一个小型补充 ED，最后，c) 应用“反向分流”并加强指导公众到办公时间服务和远离剩余 ED 的年度访问不同性别的办公时间初级保健全科医生的次数，