Do Internists and Emergency Physicians Agree on the Appropriateness of Emergency Department Visits?
Article first published online: 28 FEB 2002
1997 by the Society of General Internal Medicine
Journal of General Internal Medicine
Volume 12, Issue 3, pages 188–191, March 1997
How to Cite
O’Brien, G. M., Shapiro, M. J., Fagan, M. J., Woolard, R. W., O’Sullivan, P. S., EdD and Stein, M. D. (1997), Do Internists and Emergency Physicians Agree on the Appropriateness of Emergency Department Visits?. Journal of General Internal Medicine, 12: 188–191. doi: 10.1046/j.1525-1497.1997.012003188.x
- Issue published online: 28 FEB 2002
- Article first published online: 28 FEB 2002
- Cited By
- emergency department, appropriateness of visits;
- emergency physicians;
- physicians’ opinions
The purpose of this study was to determine the levels of agreement between three methods of assessing appropriateness of emergency department (ED) visits. In particular, we tested the agreement between internists and emergency physicians reviewing the ED nurses’ triage notes, containing information that might be available by telephone to an internist. For 892 adult patient ED visits reviewed, we found only moderate agreement (κ = 0.47) between these groups. In cases of disagreement, emergency physicians were 10.3 times more likely than internists to classify those with minor discharge diagnoses as appropriate for ED care. As managed care grows, the determination of ED appropriateness may depend on open discussions between physician groups, as well as on access to timely care in office settings.