Comparison of methods used to quantify general practice‐type patients in the emergency department: A tertiary paediatric perspective

Borland, Meredith L; Skarin, Dmitry; Nagree, Yusuf

doi:10.1111/1742-6723.12683

Cited by 9 publications

(33 citation statements)

References 25 publications

(79 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For ED patients expected to be discharged home, four out of five seen were determined by the GPs to be manageable in general practice, with about one‐third of these requiring additional skills or resources. The identified percentage of PCTED presentations was higher in outer metropolitan and rural hospitals than tertiary metropolitan hospitals, as has been seen previously . There was very good agreement between the GPs and treating ED physicians although this decreased with higher urgency ATS category.…”

Section: Discussionsupporting

confidence: 77%

“…Agreement between previous indirect criteria used to identify PCTED presentations and assessment by GPs was then examined. Table shows the percentage of ‘seen’ and ‘present’ patients who were GP‐referred, arrived by ambulance, or had a diagnosis on the list previously identified in the literature . The percentage of ‘seen’ patients who were GP‐referred (13%) was similar to those ‘present’ in the EDs (12%), and, of these, 45 (80%) were classified as PCTED presentations.…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have used lower urgency ATS categorisation as an indicator of a PCTED presentation . However, the GPs determined a large proportion in ATS categories 2 and 3 to be PCTED presentations.…”

Section: Discussionmentioning

confidence: 94%

“…Another method to quantify PCTED presentations relies on calculations of the number of self‐referred versus GP‐referred, non‐admitted, ATS category 3, 4 or 5 patients . A third method relies on self‐referred, non‐admitted, ATS category 4 and 5 patients with diagnoses on a list defined as potential GP cases …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Burden of primary care‐type emergency department presentations using clinical assessment by general practitioners: A cross‐sectional study

Whyatt

Tuson

Haynes

et al. 2019

Emerg Medicine Australasia

Self Cite

View full text Add to dashboard Cite

Objective To compare methods of assessment of the burden of primary care‐type ED (PCTED) presentations against clinical assessment by general practitioners (GPs) in ED. Methods A cross‐sectional study involving clinical assessment of patients presenting to four EDs in Western Australia. The GPs assessed patients who were likely to be discharged home from ED, and considered whether they could be managed in general practice. Patient presentations were defined by the GPs as: PCTED; PCTED if additional primary care resources were available; or not PCTED. Results GP researchers determined that 80% of patients assessed were PCTED presentations, with one‐third of these considered PCTED presentations if additional resources were available. A high proportion of identified PCTED presentations included categories excluded by previous methods. Analysis of linked data found the cohort assessed to be of lower urgency, younger, and with a shorter length of stay than the average patient being discharged from ED. After accounting for potential bias, it is suggested that 20–40% of all ED presentations could be PCTED presentations. Conclusions Previous methods determining the burden of PCTED presentations have not been validated. Many presentations excluded by previous methods were identified as manageable in general practice by GPs clinically assessing patients in ED. Improved validation of criteria used to identify PCTED presentations will enable appropriately designed interventions to reduce such events.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Burden of primary care‐type emergency department presentations using clinical assessment by general practitioners: A cross‐sectional study

Whyatt

Tuson

Haynes

et al. 2019

Emerg Medicine Australasia

Self Cite

View full text Add to dashboard Cite

show abstract

“…Furthermore, due to the use of many other diagnosis codes for children with fever, such us respiratory tract infections, this study would underestimate the full impact of childhood fever on the ED. Lastly, while the AIHW method used to classify potentially avoidable, GP‐type was dependent on the variables available in our dataset, it has been suggested that other methods may be more suitable to estimate the proportion of GP‐type patient attendees . It is important to note that there is considerable variation in the proportion of GP‐type presentations identified in the paediatric population, depending on the method used .…”

Section: Discussionmentioning

confidence: 90%

Emergency department presentations of febrile children to an Australian public hospital

Bereznicki

Tucker

Beggs

et al. 2018

J Paediatrics Child Health

View full text Add to dashboard Cite

show abstract

Exploring the measure of potentially avoidable general practitioner-type presentations to the emergency department in regional Queensland using linked, patient-perspective data

O'Loughlin¹,

Mills²,

McDermott

et al. 2021

Aust. Health Review

View full text Add to dashboard Cite

ObjectiveTo explore measures of potentially avoidable general practitioner (PAGP)-type presentations to the emergency department (ED) of a large regional hospital in northern Queensland. MethodsLinkage of an ED administrative dataset to a face-to-face patient survey of local residents (n=1000); calculation of Australian Institute of Health and Welfare (AIHW) and Australasian College of Emergency Medicine (ACEM) measures of PAGP-type presentations to the ED; and exploration of these measures with patient-perspective linked data. ResultsPAGP-type presenters to the ED were younger in age (median age in years: total cohort: 49; AIHW 38, P<0.001; ACEM 36, P<0.001); with the odds of having a chronic condition being less likely for AIHW PAGP-type presenters than other ED presenters (OR (95% CI) 0.54 (0.38–0.77): P=0.001)) after adjustment for age. PAGP-type presenters nominated reasons of convenience rather than urgency as their rationale for attending the ED, irrespective of measure. The number of PAGP-type presentations to the ED identified by the AIHW measure was more than three-fold higher than the ACEM measure (AIHW: n=227; ACEM: n=67). Influencing factors include the low proportion of ED attendees who had a medical consultation time of <1h at this hospital site (1-month survey period: 17.8%); and differences between the patient self-report and ED administrative record for ‘self-referral to the ED’ (Self-referred: Survey 71% vs EDIS 93%, P<0.001). ConclusionsIdentification of PAGP-type presentations to the ED could be enhanced with improvements to the quality of administrative processes when recording patient ‘self-referral to the ED’, along with further consideration of hospital site variation for the length of medical consultation time. What is known about the topic?PAGP-type presentations to the ED are an Australian National Healthcare Agreement progress indicator. Methods of measuring this indicator have been under review since 2012 and debate remains on how to accurately determine the measure. What does this paper add?By using patient perspective-linked data to explore different measures of PAGP-type presentations to EDs, this paper identifies issues with measure elements and suggests ways to improve these measures. What are the implications for practitioners?Measure elements of patient ‘self-referral to the ED’ and ‘medical consultation time’ require further consideration if they are to be used to measure PAGP-type presentations to the ED.

show abstract

Comparison of methods used to quantify general practice‐type patients in the emergency department: A tertiary paediatric perspective

Cited by 9 publications

References 25 publications

Burden of primary care‐type emergency department presentations using clinical assessment by general practitioners: A cross‐sectional study

Burden of primary care‐type emergency department presentations using clinical assessment by general practitioners: A cross‐sectional study

Emergency department presentations of febrile children to an Australian public hospital

Exploring the measure of potentially avoidable general practitioner-type presentations to the emergency department in regional Queensland using linked, patient-perspective data

Contact Info

Product

Resources

About