Strengths and weaknesses of the acute care systems in the United Kingdom and the Netherlands: what can we learn from each other?
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Discussion
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Implication
Comparative health systems review reveals structural drivers of emergency department crowding in acute care, suggesting cross-border adaptations to optimize patient flow.
Key Points
- To examine organizational similarities and differences in acute care delivery between the United Kingdom and the Netherlands, identifying structural strengths each country can adopt to mitigate emergency department crowding.
- Comparative health systems review assessing organizational structures, primary care integration, and patient flow across acute healthcare settings in the UK and the Netherlands.
- Evaluation of gatekeeping mechanisms, emergency department presentation volumes, hospital admission proportions, and acute ambulatory care models.
- The Netherlands experiences fewer emergency department visits per capita alongside higher hospital admission rates, facilitated by general practitioners and 24/7 general practice posts operating as primary gatekeepers.
- The UK acute care model exhibits fragmented entry points with suboptimal general practitioner access, relying on acute ambulatory care units to divert non-admitted volume away from emergency departments and acute medical units.
- Both healthcare systems face demographic shifts toward older, multimorbid patients with polypharmacy, creating a shared requirement for generalist medical leadership rather than narrow subspecialization.
Cite This Study
Kremers et al. (2019) studied this question.