General practitioner‐type patients in emergency departments in metro North Brisbane, Queensland: A multisite study

Abstract

Objective: To estimate the proportion of ED patients in urban Queensland who are potentially suitable for general practitioner (GP) care. Methods: A retrospective analysis was conducted using ED Information System data from Metro North Hospital and Health Service in Brisbane, Australia for three consecutive financial years (2014-2015 to 2016-2017). The hospitals included two Principal Referral and two Public Acute hospitals. GP-type patients were calculated using the Australian Institute of Health and Welfare (AIHW), Australasian College for Emergency Medicine (ACEM) and the validated Sprivulis methods. Results: Of the 822 841 ED presentations, 219 567 (27%) were potentially GP-type patients by AIHW, 49 307 (6%) by ACEM and 61 836 (8%) by Sprivulis methods. The higher proportion of GP-type presentations were during 08.00 to 17.00 hours by AIHW and ACEM methods. Of the loweracuity triage categories of 4 (286 154 presentations) and 5 (5658 presentations), AIHW estimated that 62% and 80% of the patients were GP-type patients, as compared to 9% and 22% by ACEM, and 9% and 0.3% by Sprivulis method. The mean costs of adult GP-type patients is $345 by the AIHW and $406 by the ACEM method, lower than non-GP type patients ($706 and $622, respectively). Conclusions: There is considerable variation in what is considered GPtype ED presentations based on the three methods employed and this variation may have fuelled the debate surrounding what is 'avoidable' ED utilisation. Regardless, the study findings provide an interesting addition to defining and addressing appropriate utilisation of ED services.

Identifying and quantifying general practice‐type emergency department presentations

“…ED demand has increased significantly in developed countries, including Australia, with resultant overcrowding, long‐waiting queues, and increased patient dissatisfaction with ED care 1–5 . In the last decade, growth in Australian ED presentations has exceeded population growth 4,6 .…”

“…Methods used to retrospectively identify general practice (GP)‐type ED presentations in Australia include the Australasian College for Emergency Medicine (ACEM) method, 2,3 Australian Institute of Health and Welfare (AIHW) method, 2,8 Diagnosis method 2,9 and Sprivulis method 3,10 . The ACEM method is the most frequently used method in the literature and is better validated 1–3,9 . The ACEM method defines a GP‐type patient as one who does not arrive by ambulance, is self‐referred and has a medical consultation time (MCT) of less than 60 min 1,3 .…”

Health and support service needs of individuals with disability from culturally and linguistically diverse backgrounds: a scoping review protocol

“…Primary care is usually the first contact an individual has with the health system and covers the majority of an individual's health needs, and delivers community-based care by various health professionals [37,47,48]. Secondary care requires more specific knowledge, skills, and equipment and is provided by a specialist or hospital upon referral by a primary care professional [49].…”

Health and support service needs of individuals with disability from culturally and linguistically diverse backgrounds: a scoping review protocol

“…Primary care is usually the rst contact an individual has with the health system and covers the majority of an individual's health needs, and delivering community-based care by various health professionals [37,47,48]. Secondary care requires more speci c knowledge, skills and equipment and is provided by a specialist or hospital upon referral by a primary care professional [49].…”