Introduction: Low-urgency patients presenting to the emergency outpatient service can be problematic and can make it difficult for a hospital to accept an ambulance or other high-urgency patients. Consequently, some hospitals have restricted the admittance of low-urgency patients presenting to the emergency outpatient service by introducing an after-hours medical surcharge. In this study, we report the effect of an after-hours medical surcharge at the oral and maxillofacial surgery emergency outpatient service.
Materials and Methods: The subjects were 4,664 emergency patients who presented at the oral and maxillofacial surgery emergency outpatient service at Tokyo Women’s Medical University Hospital over a period of 6 years between April 2006 and March 2013. We compared the number of patients in the emergency service with and without levying an after-hours medical surcharge.
Results: The number of low-urgency patients decreased from 850 patients/year to 612 patients/year following the introduction of the after-hours medical surcharge. The number of patients presenting with teeth disease decreased from 24.7% to 15.4%. The number of patients requiring ambulance transport increased from 11.7% to 15.0%. The number of emergency admissions increased from 3.9% to 5.9%.
Conclusion: The after-hours medical surcharge effectively decreased the low-urgency patients presenting to the oral and maxillofacial surgery emergency outpatient service.
