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]
© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
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 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 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)|
|Year Published:||2016 (online first 2015)|
|Web of Science® Times Cited:||8|
Repository Staff Only: item control page