Exploring factors that influence adult presentation to an emergency department in regional Queensland: A linked, cross‐sectional, patient perspective study

O'Loughlin, Mary Ann; Harriss, Linton; Thompson, Fintan; McDermott, Robyn; Mills, Jane

doi:10.1111/1742-6723.13094

Cited by 6 publications

(10 citation statements)

References 13 publications

(13 reference statements)

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“…Analyses of this patient survey have been reported elsewhere. 16 In the study period, 3229 individual adults (aged !18 years) attended the ED including international, inter-state and intrastate visitors. For this present study, only adults who agreed to participate in the survey and self-identified as residing locally were included in the data linkage (n ¼ 1014).…”

Section: Study Population and Settingmentioning

confidence: 99%

“…Our study was limited in several ways; the study sample was sourced from the ED waiting room; when compared with the wider ED cohort, earlier research indicated that this sample was typical for gender but slightly older in age; 16 study respondents were more likely to have arrived by ambulance and to be discharged home; 16 the patient survey was a piloted, but non-validated tool that had previously been used by health services; 16 and our study involved one hospital and further investigation is indicated to inform on other sites.…”

Section: Limitationsmentioning

confidence: 99%

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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

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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.

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Section: Study Population and Settingmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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

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“…In a study published elsewhere, we explored factors that influenced the presentation of adults to the Cairns Hospital ED. Ethics approval for the study was obtained from the Far North Queensland Human Research Ethics Committee (reference, HREC/16/QCH/81‐1068).…”

mentioning

confidence: 99%

“…1 Inaccurate representation of Indigenous status in datasets has been previously identified, and government agencies have been directed to improve data quality, and particularly to reduce the underreporting of Indigenous status. 2,3 In a study published elsewhere, 4 we explored factors that influenced the presentation of adults to the Cairns Hospital ED. Ethics approval for the study was obtained from the Far North Queensland Human Research Ethics Committee (reference, HREC/16/ QCH/81-1068).…”

mentioning

confidence: 99%

Validating Indigenous status in a regional Queensland hospital emergency department dataset with patient‐linked data

O'Loughlin

Harriss

Mills

et al. 2019

Medical Journal of Australia

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“…Six studies reported on the proportions of patients seeking alternative care or advice before visiting an ED [12,18,19,20,21,22]. While more information could be inferred from some of the referral data, we chose to present data from studies that speci cally reported on advice seeking or patient pathways to the ED.…”

Section: Resultsmentioning

confidence: 99%

Patients’ pathways to the emergency department: a scoping review

Nummedal

King

Uleberg

et al. 2023

Preprint

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Background Emergency Department (ED) crowding is a common healthcare issue. The causes are multifactorial, and some causes may be found by analyzing patient trajectories prior to ED visits. The aim of this scoping review is to identify and examine studies that describe patient trajectories prior to ED arrival. Methods The scoping review was performed according to the JBI Manual for Evidence Synthesis and the PRISMA-SCR checklist. A literature search was done to identify studies describing where patients come from and/or their pathway of care before the ED visits. The search was conducted in MEDLINE, Embase, and the Cochrane Library from inception up to March 17th, 2022 and updated on December 5th, 2022. Two reviewers independently screened the records at all stages of the review process. Results Out of 6,465 records screened, 14 papers from Australia, Canada, Haiti, Norway, Sweden, Switzerland, Belgium, Indonesia and the UK met the inclusion criteria. Four studies reported on where patients originated from. Seven studies reported on who referred them. Ten reported how patients were transported and five reported if alternative care or advice was sought prior to visiting an ED. Data were sparse for these categories of information; not all studies reported the full spectrum of patients within each category. Conclusion There are knowledge gaps when it comes to describing patients’ pathways to the emergency department. The data reported provided limited insight, and the lack of uniform data prohibits comparisons across studies. Further studies that comprehensively describe patient trajectories prior to an ED visit are paramount to help understand the reasons for the increased patient influx and ED crowding.

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Exploring factors that influence adult presentation to an emergency department in regional Queensland: A linked, cross‐sectional, patient perspective study

Cited by 6 publications

References 13 publications

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

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

Validating Indigenous status in a regional Queensland hospital emergency department dataset with patient‐linked data

Patients’ pathways to the emergency department: a scoping review

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