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Emergency medicine in the Netherlands, the necessity for changing the system: results from two questionnaires

van Geloven, Anna A.W.; Luitse, Jan S.K.; Simons, Maarten P.; Volker, Beijtje S.; Verbeek, Marjos J.; Obertop, Hugo

European Journal of Emergency Medicine: December 2003 - Volume 10 - Issue 4 - p 318-322
ORIGINAL ARTICLE
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Objective: To obtain information about patient, staff and organization characteristics of Emergency Departments in the Netherlands, and evaluate the changes between 1996 and 1999.

Methods: The heads of the Emergency Departments of all hospitals in the Netherlands were sent a questionnaire concerning patient, staff, and organization characteristics, as well as questions about intended future developments. The results were compared with data obtained from a comparable questionnaire in 1996.

Results: In the Netherlands, 113 hospitals (113/126) have an Emergency Department; 105/113 returned the questionnaire (93%). Ninety-two percent of the hospitals reported an increase in annual Emergency Department census and in the number of self-referred patients. The number of Emergency Departments staffed by only surgical residents decreased (52% in 1996 versus 41% in 1999), whereas the number of hospitals employing emergency physicians increased (24% in 1996 versus 45% in 1999). In 92% of the hospitals, nurses who work in the Emergency Department receive specific training. For emergency physicians, a specific training programme is not available, and in fact 30% of the physicians did not have any specific emergency medicine training. Therefore, none of the emergency physicians were fully trained in emergency medicine. According to 88% of all responders, there is a future for emergency medicine as an independent speciality in the Netherlands, and 35% of all hospitals intend to initiate a training programme for emergency physicians in the future.

Conclusion: Almost all hospitals in the Netherlands reported an increase in the number of patients visiting the Emergency Department, especially in the number of self-referred patients. A majority of the Emergency Departments are now staffed by emergency physicians instead of surgical residents. Developing specific training programmes for emergency physicians should be a priority for the Netherlands in the future.

Academic Medical Centre, Department of Surgery, Amsterdam, the Netherlands

Correspondence to Anna A.W. van Geloven, Churchilllaan 176-II, 1078 ES Amsterdam, the Netherlands

Tel/fax: +31 20 6623726; e-mail: nvangeloven@zonnet.nl

© 2003 Lippincott Williams & Wilkins, Inc.