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Extending the opening hours of family medicine clinics will reduce load on emergency departments – effects on the early detection of limb fractures

Aisha Yousuf, Darine Helmy Saad, Nada Najib Mulla, Amna Hassan
Scheduled to Publish in : HAMDAN MEDICAL JOURNAL ; Future Issues
DOI : 10.7707/hmj.690

Abstract


Patients with serious and non-serious limb complaints are diverted to emergency departments (EDs) at night, when regular clinics are closed. This study was conducted to identify the impact of extending the opening hours of family medicine (FM) clinics on the detection of limb fractures in patients with limb complaints, which could be a measure of expected patient influx in EDs. A cross-sectional comparative study was conducted in a health centre in Dubai, United Arab Emirates. Patients with limb complaints were categorized by attendance during regular hours (7:30–21:30 hours) and extended hours (21:30–7:30 hours). Rates of fracture positivity, patients handled by the FM clinic and patients referred by the FM clinic to other departments were analysed. SPSS Statistics version 24 (IBM Corporation, Armonk, NY, USA) was used for analysis; chi-squared tests were used to determine association and P-values <0.05 were considered significant. A total of 736 patients with limb complaints were studied: 81.79% (602) attended the FM clinic during regular hours and 18.21% (134) attended during extended hours. The total number of fracture-positive patients was 108. Fracture positivity was more frequent during extended hours: 23 of 134 (17.16%) patients were fracture positive during extended hours and 85 of 602 (14.11%) patients were fracture positive during regular hours. Only 30 of 134 (22.38%) patients were referred to the ED or another department during extended hours, whereas 150 of 602 (24.91%) patients were referred to the ED or another department during regular hours. Referral of fracture-positive patients was not affected by time of attendance (P>0.05). More fracture-positive patients and fewer referrals during extended hours indicates the significance of extending clinic opening hours; extending the opening hours of this clinic to 24 hours indirectly reduced ED crowding.


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