Kommer GJ, Gijsen R, de Bruin-Kooistra M, Deuning C
RIVM Report 2017-0108
RIVM surveyed the supply and accessibility of hospitals in the Netherlands that provided emergency care in April 2017. This was also done for acute obstetrics. The results show that these hospitals are spread across the Netherlands in such a way that 99.8 percent of the residents can be transported to an emergency medical department (A&E) or hospital with acute obstetrics within 45 minutes, according to the accessibility model.
In April 2017, there were 89 A&Es that were open 24/7. That is one less than in 2016 and two less than in 2014. Acute obstetrics was provided 24/7 at 81 hospital locations. That is the same as in 2016 and three less than in 2014. The locations of ambulance stations were also updated in the inventory. Since the last update in 2013, thirteen ambulance stations were added and some stations were relocated.
This accessibility analysis looked at the distribution of hospitals throughout the Netherlands. The analysis determines how many hospitals are considered 'sensitive'. There are now ten sensitive hospitals with a 24/7 basic A&E. The accessibility analysis for acute obstetrics results in twelve sensitive hospitals. A hospital is designated as such if, according to the theoretic model, the number of residents that may take more than 45 minutes to be brought to an A&E increases when this hospital closes. The duration of the ride is calculated based on the time the ambulance requires to get from the station via the patient's residence to the hospital. This model-based ride time is then compared with the 45-minute distribution standard.
This study also examined the presence and accessibility of, among others, specialists, nurses and facilities to make the diagnoses at the A&Es and start treatment. The collaboration between the A&Es and the out-of-hours GP services was also examined. In 42 cases, the 24/7 A&E and out-of-hours GP services were integrated, with a joint entrance and a procedure for people who report for emergency care with less urgent/complex complaints on their own initiative.