Strategies to identify medical patients suitable for management through Same Day Emergency Care Services: A Systematic Review.

Same Day Emergency Care (SDEC) in unplanned and emergency care is an NHSE priority. Optimal use of these services requires rapid identification of suitable patients. NHSE suggests the use of one tool for this purpose. This systematic review compares studies which evaluate the performance of selection tools for SDEC pathways. Nine studies met the inclusion criteria. Three scores were evaluated: the Amb score (7 studies), Glasgow Admission Prediction Score (GAPS)(6 studies) and Sydney Triage to Admission Risk Tool (START)(2 studies). There was heterogeneity in the populations assessed, exclusion criteria used, and definitions used for SDEC suitability, with proportions of patients deemed 'suitable' for SDEC ranging from 20-80%. Reported score sensitivity and specificity ranged between 18-99% and 10-89%. Score performance could not be compared due to heterogeneity between studies. No studies assessed clinical implementation. The current evidence to support the use of a specific tool for SDEC is limited and requires further evaluation.

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Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.