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Low‐acuity presentations to regional emergency departments: What is the issue?
Author(s) -
Cheek Colleen,
Allen Penny,
Shires Lizzi,
Parry Denise,
Ruigrok Marielle
Publication year - 2016
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12526
Subject(s) - medicine , emergency department , triage , context (archaeology) , retrospective cohort study , referral , medical emergency , emergency medicine , visual acuity , family medicine , nursing , ophthalmology , paleontology , biology
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.