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Low-acuity presentations to regional emergency departments: What is the issue?


Cheek, C and Allen, P and Shires, L and Parry, D and Ruigrok, M, Low-acuity presentations to regional emergency departments: What is the issue?, Emergency medicine Australasia, 28, (2) pp. 145-152. ISSN 1742-6731 (2016) [Refereed Article]

Copyright Statement

2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

DOI: doi:10.1111/1742-6723.12526


Objective: To explore GP-referrals and self-referrals to EDs and factors associated with patients seeking low-acuity care at ED.

Method: Retrospective analysis of all ED presentations to Mersey Community Hospital and North West Regional Hospital (Tasmania) between 1 January 2009 and 31 December 2013. Cross-sectional survey of patients presenting to the EDs for care triaged as low-acuity.

Results: There were 255  365 ED presentations in the retrospective data: 11  252 (4.4%) GP-referrals and 218  205 (85.4%) self-referrals. At ED 49% of GP-referrals were triaged ATS 4 or 5 and 35% of self-referrals were triaged ATS 1-3. There were 138 (84.2%) low-acuity patients who completed the survey; predominantly, all attended for acute injury or illness. Single point-of-care convenience was most commonly selected (71%) as a reason for attending ED.

Conclusions: Over 85% of patients who seek emergency care in this region self-refer, so understanding health-seeking behaviour is important. Most low-acuity patients are acutely injured or unwell, and the decision to go to ED is based on their perception of accessibility of expertise aligned with their need. The term 'GP-type' is misleading in this context and should not be used. Providing low-acuity care in parallel with providing a specialised emergency service meets the needs of the local community and is likely to be the lowest cost model in a regional and rural area. Funding models must reflect the actual cost of delivering this important service rather than presentation types.

Item Details

Item Type:Refereed Article
Keywords:cost, demand, funding, general practice, health-seeking behaviour, low-acuity presentations, regional hospital, emergency care, regional hospital
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health and community services
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Rural and remote area health
UTAS Author:Cheek, C (Dr Colleen Cheek)
UTAS Author:Allen, P (Dr Penny Allen)
UTAS Author:Shires, L (Professor Lizzi Shires)
ID Code:106009
Year Published:2016 (online first 2015)
Web of Science® Times Cited:11
Deposited By:Medicine
Deposited On:2016-01-25
Last Modified:2017-11-05

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