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

Citation

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

Abstract

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:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Health and Community Services
Objective Division:Health
Objective Group:Specific Population Health (excl. Indigenous Health)
Objective Field:Rural Health
Author:Cheek, C (Mrs Colleen Cheek)
Author:Allen, P (Dr Penny Allen)
Author:Shires, L (Dr Lizzi Shires)
ID Code:106009
Year Published:2016 (online first 2015)
Web of Science® Times Cited:2
Deposited By:Medicine (Discipline)
Deposited On:2016-01-25
Last Modified:2016-11-16
Downloads:0

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