Evaluation of Diagnostic and Treatment Processes for Patients Referred by Primary Care Physicians to the Emergency Department of Lsmu Kk

Introduction Emergency departments (ED) focus on treating acute, life-threatening conditions. However, overcrowding since the 1980s had led to increased mortality and reduced care quality, affecting both patients and staff [1]. Primary care physicians (PCP) play a crucial role in patient assessment and ED referrals. Optimizing primary care-ED collaboration and referral processes is essential for efficient care [2]. Aim To analyse the diagnostic and treatment processes of patients referred by PCP to the ED of Lithuanian University of Health Sciences Kauno Klinikos (LSMU KK). Methods We conducted a retrospective, descriptive study analyzing patients’ medical records who were referred to the ED of LSMU KK in December 2023. Results Durning the study period, 430 patients who were referred by primary care physicians visited the ED of LSMU KK. The most common referral indications were cardiovascular diseases ( n﹦65 (15%)) and intra-abdominal pathologies (n﹦64 (15 %). The most frequently performed diagnostic procedures included blood test (68%) and computer tomography (31%), ultrasound (29%). For 265 (62%) patients a consultant was called. A total of 57 interventions were performed (ophthalmoscopy, abscess treatment, electrical cardioversion etc.) and pharmacological treatment was prescribed to 146 (34%) patients. Nine percent of the referrals were considered inappropriate. A statistically significant higher number of study group patients were hospitalized compared to non-PCP referred patients: 116 (27%) vs 1045 (18%), p < 0.001. Sixty percent of the patients were discharged. Average hospital treatment days were 10 ± 11,6 and 3 patients died. Conclusions The study revealed that a significant number of patients referred by PCP had serious health conditions; however, a majority of the study group were discharged. This highlights the importance of strengthening PCP capabilities, improving access to laboratory and radiological examinations and integrating ultrasound training into medical education programs.