Potential role of general practice in reducing emergency department demand: A qualitative study

Willson, Katie A; Lim, David; Toloo, Ghasem Sam; FitzGerald, Gerry; Kinnear, Frances; Morel, Douglas

doi:10.1111/1742-6723.13964

Cited by 9 publications

(9 citation statements)

References 20 publications

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“…In the shorter term, the Government has also committed to increasing the number of urgent care centres [ 31 ], however it remains to be seen how these will be staffed. As articulated by Wilson et al, “a whole of system approach” is needed to realign policy priorities in this setting [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Understanding patient preferences for emergency care for lower triage acuity presentations during GP hours: a qualitative study in Australia

Korczak

Yakubu

Angell

et al. 2022

BMC Health Serv Res

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Background Low acuity presentations to Australian emergency departments drive long wait times, higher costs and may be better treated in primary care settings. This study sought to understand factors leading these patients to present to emergency departments. Methods Semi-structured interviews were carried out with patients at two tertiary emergency departments in Sydney during general practitioner opening hours. Nvivo was used to code the interviews and a thematic analysis was carried out to capture the main themes from the interviews. Results Forty-four interviews were included in the analysis across the two sites. They represented a diverse population in terms of ethnicity, education and socioeconomic background. Patient preferences for emergency care were organised into four main themes: (i) patients were referred (either by another health service, work, friend, or family), (ii) emergency department factors (convenience of investigations and severity of symptoms requiring emergency care), (iii) GP factors (does not have a GP, cannot find an appointment with a GP or has previously had a negative experience with a GP) and (iv) personal factors such as their connection to the hospital. Conclusion Multiple factors led patients to seek ED care for low acuity presentations during GP hours. Some of these factors could be addressed to meet patient needs in the community, however this is currently not the case. Addressing these factors to improve access to GP clinics and the availability of services outside the hospital setting could reduce ED presentations and likely improve patient experience.

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Section: Discussionmentioning

confidence: 99%

Understanding patient preferences for emergency care for lower triage acuity presentations during GP hours: a qualitative study in Australia

Korczak

Yakubu

Angell

et al. 2022

BMC Health Serv Res

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“…The effectiveness of a wide range of interventional approaches to reduce ED use (including health education and PC strengthening, but also quite different measures such as telephone triage and prehospital diversion) has been reviewed,17 18 and assessment remains hampered by deficient evidence. It has been repeatedly suggested that strengthening PC by reducing access barriers and promoting care continuity may attenuate the demand for ED services 19–22. Previous investigations of our working group have identified patient education about alternative care options and self-assessment of symptoms, as well as measures to ameliorate PC access problems, as potentially promising interventional gateways 23.…”

Section: Introductionmentioning

confidence: 95%

“…It has been repeatedly suggested that strengthening PC by reducing access barriers and promoting care continuity may attenuate the demand for ED services. 19–22 Previous investigations of our working group have identified patient education about alternative care options and self-assessment of symptoms, as well as measures to ameliorate PC access problems, as potentially promising interventional gateways. 23 However, while motives for visiting EDs have been extensively explored, far less is known about patients’ views on redirection into PC and their openness towards different interventional approaches.…”

Section: Introductionmentioning

confidence: 99%

Exploring the views of low-acuity emergency department consulters on an educational intervention and general practitioner appointment service: a qualitative study in Berlin, Germany

et al. 2023

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ObjectivesLow-acuity patients presenting to emergency departments (EDs) frequently have unmet ambulatory care needs. This qualitative study explores the patients’ views of an intervention aimed at education about care options and promoting primary care (PC) attachment.DesignQualitative telephone interviews were conducted with a subsample of participants of an interventional pilot study, based on a semi-structured interview guide. The data were analysed through qualitative content analysis.SettingThe study was carried out in three EDs in the city centre of Berlin, Germany.ParticipantsThirty-two low-acuity ED consulters with no connection to a general practitioner (GP) who had participated in the pilot study were interviewed; (f/m: 15/17; mean age: 32.9 years).InterventionIn the pilot intervention, ED patients with low-acuity complaints were provided with an information leaflet on appropriate ED usage and alternative care paths and they were offered an optional GP appointment scheduling service. Qualitative interviews explored the views of a subsample of the participants on the intervention.ResultsInterviewees perceived both parts of the intervention as valuable. Receiving a leaflet about appropriate ED use and alternatives to the ED was viewed as helpful, with participants expressing the desire for additional online information and a wider distribution of the content. The GP appointment service was positively assessed by the participants who had made use of this offer and seen as potentially helpful in establishing a long-term connection to GP care. The majority of patients declining a scheduled GP appointment expected no personal need for further medical care in the near future or preferred to choose a GP independently.ConclusionsLow-acuity ED patients seem receptive to information on alternative acute care options and prevailingly appreciate measures to encourage and facilitate attachment to a GP. Promoting PC integration could contribute to a change in future usage behaviour.Trial registration numberDRKS00023480.

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“…However, many studies called for better enhancing emergency case management at the PHC levels, thus decreasing the load on the emergency department and helping in stabilization and early initiation of diagnosis and management of emergency cases. It is also recommended that more integration between PHC and emergency departments should be planned [ 4 , 7 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers Impact the Primary Healthcare Providers When Dealing With Emergency Cases: A Cross-Sectional Study in Al-Ahsa, Saudi Arabia

AlAbdullah,

Al Ahmed,

Alatiyyah

et al. 2024

Cureus

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Introduction Being the first in-line care providers, primary healthcare (PHC) physicians may encounter all forms of medical emergencies, ranging from minor complaints to major life‐threatening events; therefore, this study aims to assess the PHC physicians’ knowledge and attitude related to the diagnosis and management of emergency cases as well as their preferences for emergency medicine training courses and their preferred methods of training. Methods A descriptive cross-sectional study was conducted among physicians working at PHC in Al-Ahsa, Saudi Arabia, between November and December 2023, excluding those who do not work at PHC. The minimum required sample size was 192. A self-administered online questionnaire was developed using Google Forms and distributed conveniently through social media platforms. It consists of 22 items categorized into four sections: The first section focused on demographic information; the second section assessed knowledge related to the diagnosis and management of emergency cases commonly encountered in PHC, along with actual management experiences; the third section gauged physicians' attitudes, and the fourth section explored participants' preferences for emergency medicine courses and their preferred methods of training in this field. The Kruskal-Wallis rank sum and Wilcoxon rank sum tests were employed to identify predictors of knowledge and attitude. Results The study involved 193 participants, with 96 (50%) females and a median age of 30 years. The participants included 43 (22%) consultants, 69 (36%) family residents, 30 (16%) general practitioners, and 50 (26%) specialists. Participants reported a median of 4.0 years of experience in PHC in Saudi Arabia. The majority, 69 (36%), reported working in the hospital emergency department, with a reported median duration of three months. Roughly 84% of PHC physicians had a positive attitude toward emergency cases diagnosis and management, while 92% showed fair diagnostic knowledge of emergency cases, and 73% showed fair management knowledge. Higher knowledge in the diagnosis and management of PHC was linked to increasing age, being consultants, being employed in the emergency department, and having higher years of experience in PHC (p < 0.05). A positive attitude toward PHC was found to be associated with working as a consultant and being employed in the emergency department (p < 0.05). Approximately 133 (68.9%) expressed a preference for a course in wound care trauma, followed by central nervous system emergencies (n = 124, 64.2%), coronary artery disease emergencies (n = 116, 60.1%), and obstetrics/gynecologic emergencies (n = 114, 59.1%) with 160 (82.9%) favored training through practice in PHC under supervision of qualified staff. Conclusion While many PHC centers are well equipped and prepared for early stabilization and management of emergency cases, PHC physicians showed low competency in dealing with emergency cases. This indicates a great need...

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Potential role of general practice in reducing emergency department demand: A qualitative study

Cited by 9 publications

References 20 publications

Understanding patient preferences for emergency care for lower triage acuity presentations during GP hours: a qualitative study in Australia

Understanding patient preferences for emergency care for lower triage acuity presentations during GP hours: a qualitative study in Australia

Exploring the views of low-acuity emergency department consulters on an educational intervention and general practitioner appointment service: a qualitative study in Berlin, Germany

Barriers Impact the Primary Healthcare Providers When Dealing With Emergency Cases: A Cross-Sectional Study in Al-Ahsa, Saudi Arabia

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