• Olivier T Rutschmann and Bernard Vermeulen.
• Département de Médecine Interne Centre d'Accueil et d'Urgences, Hôpitaux Universitaires de Genève. olivier.rutschmann@hcuge.ch
• Rev Med Suisse Romande. 2003 Feb 1; 123 (2): 109-12.

AbstractOvercrowding of emergency departments (ED) is on increasing concern and results from (1) patients using ED as their primary source of care, (2) aging of the population, (3) poor coordination between home care services and primary care physicians. Two groups of patients can be targeted to reduce the use of ED services. First, selected patients with acute conditions can be included in home hospitalization programs. In these programs home care services deliver complex treatment to patients with acute conditions under the supervision of their physician. Strong links between home care agencies and primary care physicians are required for the success of these programs and may limit their diffusion in non integrated delivery systems of care. Second, patients with chronic diseases may benefit from disease management programs which have been shown to reduce hospitalizations and cost-saving.

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