Private (17%) and public (83%) hospitals were represented. The 53 EDs were classified according to the following two strata: the number of annual visits to these EDs (high attendance (25 000 or over visits per year) and medium or low attendance (less than 25 000 visits per year)) and, the geographical location of EDs (located urban area characterized by higher population

density with at least 2 000 residents and by the urban-type land use, Inhibitors,research,lifescience,medical not allowing any gaps of typically more than 200 meters [28] or not). Finally, 17 EDs were randomly selected among the 53 EDs according the two strata. Table ​Table11 describes the characteristics of these 17 EDs. Table 1 Hospital Characteristics Population and Data collection Inhibitors,research,lifescience,medical All patients aged 18 years and older who presented in one of participant EDs between the hours of 8 AM and 12 midnights were included. Study hours were limited because of few patients come after midnight [29]. Patients were excluded if they required immediate medical care and had communication difficulties. Immediately after the admittance and nurse triage, all patients agreeing to participate were interviewed face to face in the ED by a trained research assistant who was not involved in care. The anonymous standardized questionnaire collected the following variables Inhibitors,research,lifescience,medical [Additional file 1]: – Patients’

characteristics: demographic (age, sex) and socio-economic characteristics (employment status, selleck catalog health insurance status), utilization of health care services (having a primary care physician, Yes/No response from the patient), health status (suffering from chronic disease, Yes/No response from the patient). – ED visit characteristics: Inhibitors,research,lifescience,medical type of referral to the ED (self-referral, health care professional or other referral i.e. Inhibitors,research,lifescience,medical police, ambulance, employer, school, sports facility), chief complaint, duration of the presenting complaint, and mode of arrival. At the end of the ED consultation, the research assistant collected if the patient had diagnostic Brefeldin_A tests and treatments performed in the ED, and visit disposition

(hospitalization). Moreover, during their activity, trained triage nurses, after the admittance, and trained ED physicians, immediately at the end of the consultation, were asked to complete the questionnaire for each patient seen [Additional file 2]. They independently gave their expert opinion concerning the urgency of the admission of the patient. All ED health professionals had at least one year’ experience of the ED. Categorization of the urgency of the ED admission According to the CHIR99021 clinical trial literature review, patients categorized as nonurgent are defined as those “who could have been dealt with by general practitioner” [10]. The categorization was conducted in two times and from two categories of ED health care professionals.