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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 |
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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: | 10 |
Deposited By: | Medicine |
Deposited On: | 2016-01-25 |
Last Modified: | 2017-11-05 |
Downloads: | 0 |
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