Urgent vs emergency & the role of general practicioners

I wanted to add all the huisartsenwachtpost (BE-Dutch) / Postes médicaux de garde (BE-French) in Belgium. These are places where a general practitioner is available outside of regular office hours, and where you can get urgent care for things that a GP can take care of. This system is in place largely to avoid queues in the Emergency wards, and to make the out-of-hours duties of GPs more efficient.

Similar concepts exist elsewhere:

  • Huisartsenposten (NL) > obligatory (?) step before going to the Emergency Ward
  • Urgent treatment centres (UK) > Urgent treatment centres (UTCs) provide urgent medical help when it’s not a life-threatening emergency.
    Open at least 12 hours a day, every day, UTCs offer appointments that can be booked through NHS 111 (telephone and online) and are equipped to investigate, diagnose, and deal with many of the most common injuries and illnesses people attend Emergency Departments (A&E) for.
    ( NHS England » Urgent treatment centres )
  • Bereitschaftspraxis (DE) > “on call practices”, “Notdienst”, 116117
  • Urgent care centre (US) > out of office urgent care for non-emergency situations

When looking for a proper tag, I settled on amenity=doctors + healthcare:speciality=emergency, because the phrasing on the wiki seems like a fit: These cases are usually handled at a “first aid medical station,” which is a medical facility that is open permanently or at least outside the regular office hours of general practitioners (nights, weekends, holidays).

But digging a little deeper, I guess the whole topic is in need of some refining.

We have:

  1. Emergency ward wiki

Which describes:

  • entrance is indicated emergency=emergency_ward_entrance
  • facility itself: just as amenity=clinic + emergency=yes or sometimes healthcare=emergency_ward
  1. healthcare:speciality=urgent. The place where admissions into a hospital are triaged
    “Emergency Room,” “Emergency,” or “Urgent Admissions,”
  2. healthcare:speciality=emergency
    The service of people specialising in immediate medical attention.

The difference between 2 and 3 seems pretty small and doesn’t seem to follow default definitions in the sector. E.g. this text from the NHS in the UK:

  • Emergency care involves life-threatening illnesses or accidents which require immediate treatment from the ambulance service (via 999) and an emergency department (A&E).
  • Urgent care involves any non-life-threatening illness or injury needing urgent attention which might be dealt with by phone consultation through the NHS111 Clinical Assessment Service, pharmacy advice, out-of-hours GP appointments, and/or referral to an urgent treatment centre (UTC).

While the text is from the UK, considering the “urgent care centers” in the US, I assume the meaning is relatively universal.

So to me, it seems like we should adapt the urgent/emergency pages to make that same distinction: emergency is for life threatening problems and things that have to be dealt with now, urgent for other things that should be dealt with soon

So all the examples at the top of this post would be amenity=doctors|clinic|whatever with healthcare:speciality=urgent

I also got the suggestion to use out-of-hours_service=yes or simply rely on opening_hours . The former would work for me, but would be completely new. The latter seem unpractical and miss the specificity of the service offered (it’s not simply a GP open at night, because you’re not going there for non-urgent things).

what if only specific emergencies are dealt with? For example I came along a gynecological hospital which has a 24/7 emergency department, ambulances arrive etc., but only for gynecological emergencies. Is dealing with “emergency”-related situations really a good fit for the healthcare specialty tagging, or maybe it would be better to have something like healthcare:emergency=* ?

For the list of similar concepts I suggest also these from Italy:

  • Guardia medica (“Medical guard”), staffed by general practitioners who cover evenings, nights and other hours when family doctors are unavailable. It has no official tagging scheme but the de facto standard documented on the wiki is amenity=doctors + healthcare=doctor
  • CAU (Centro di Assistenza e Urgenza, “Urgency and assistance centre”), facilities staffed by GPs and nurses, designed to handle non-life-threatening but urgent cases, sitting between the Guardia Medica and the Emergency Ward in terms of urgency. After being discussed in this thread it was documented on the wiki to be mapped with amenity=clinic + healthcare=clinic

In Australia we have Medicare Urgent Care Clinics (where you may need more urgent care than a normal GP appointment, but not life threatening enough to go to the hospital emergency, often they will have in-hours radiology for xrays, indeed they were created to take the easy of the hospital emergency department), add Medicare Urgent Care Clinics for AU by andrewharvey · Pull Request #11795 · osmlab/name-suggestion-index · GitHub which are suggested as amenity=clinic/healthcare=clinic since they fit somewhere between amenity=doctor (ie. a “GP clinic” / “doctors office” / “medical center”) and amenity=hospital. I think amenity/healthcare=clinic is the main tag needed, with potentially some combination of brand/operator if they are part of a network of urgent care centres.

The healthcare:speciality=urgent was included since the tag is within use and on the wiki, but it’s not really a speciality in the same sense as for example a gynaecologist.

emergency=emergency_ward_entrance is usually used to identify the entrance to the emergency ward of a hospital. Since the hospital main entrance may be at a different location to the emergency ward/department entrance of the hospital.