Health systems invest in coordination and collaboration between emergency departments (ED) and after-hours primary care providers (AHPCs) to alleviate pressure on the acute care chain. There are substantial gaps in the existing evidence, limited in sample size, follow-up care, and costs. We assess whether acute care collaborations (ACCs) are associated with decreased ED utilization, hospital admission rates, and lower costs per patient journey, compared with stand-alone facilities. The design is a quasi-experimental study using claims data. The study included 610 845 patients in the Netherlands (2017). Patient visits in ACCs were compared to stand-alone EDs and AHPCs. The number of comorbidities was similar in both groups. Multiple logistic and gamma regressions were used to determine whether patient visits to ACCs were negatively associated with ED utilization, hospital admission rates, and costs. Logistic regression analysis did not find an association between patients visiting ACCs and ED utilization compared to patients visiting stand-alone facilities [odds ratio (OR), 1.01; 95% confidence interval (CI), 1.00–1.03]. However, patients in ACCs were associated with an increase in hospital admissions (OR, 1.07; 95% CI, 1.04–1.09). ACCs were associated with higher total costs incurred during the patient journey (OR, 1.02; 95% CI, 1.01–1.03). Collaboration between EDs and AHPCs was not associated with ED utilization, but was associated with increased hospital admission rates, and higher costs. These collaborations do not seem to improve health systems’ financial sustainability.

卫生系统投资于急诊科 (ED) 和非工作时间初级保健提供者 (AHPC) 之间的协调与协作，以减轻急症护理链的压力。现有证据存在巨大差距，且样本量、后续护理和费用有限。我们评估与独立设施相比，急症护理协作 (ACC) 是否与急诊室利用率降低、住院率降低以及每位患者就诊成本降低有关。该设计是使用索赔数据的准实验研究。该研究纳入了荷兰的 610 845 名患者（2017 年）。将 ACC 的患者就诊与独立的 ED 和 AHPC 进行比较。两组的合并症数量相似。使用多重逻辑回归和伽马回归来确定患者就诊 ACC 是否与 ED 使用率、住院率和费用呈负相关。与访问独立设施的患者相比，Logistic 回归分析未发现访问 ACC 的患者与 ED 使用率之间存在关联 [比值比 (OR)，1.01；比值比 (OR)，1.01；95% 置信区间 (CI), 1.00–1.03]。然而，ACC 中的患者与入院率增加相关（OR，1.07；95% CI，1.04-1.09）。ACC 与患者旅程中产生的较高总成本相关（OR，1.02；95% CI，1.01-1.03）。急诊室和 AHPC 之间的合作与急诊室的利用率无关，但与住院率增加和费用增加相关。这些合作似乎并没有改善卫生系统的财务可持续性。