Primary care patients' views on why they present to Emergency Departments: Inappropriate attendances or inappropriate policy?

Siminski, Peter; Cragg, Susan; Middleton, Rebekkah; Masso, Malcolm R; Lago, Luise P; Green, Janette P; Eagar, Kathy

doi:10.1071/py05026

Cited by 21 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 socioeconomic characteristics; 6,18 influence of family opinion; 6 limited access to primary care, 6 availability of services in hospital; 19,20 lack of self care; 6,21 and a lack of social supports. 12,22,23 Our understanding of the importance of these factors in terms of EDs arises from analyses of older people's presentation to EDs regardless of triage category.…”

mentioning

confidence: 99%

The ‘unnecessary’ use of emergency departments by older people: findings from hospital data, hospital staff and older people

Faulkner

Law

2015

Aust. Health Review

View full text Add to dashboard Cite

Objective. Increasing demands are being placed on emergency departments in Australia and there is a view that older Australians are more likely than other age groups to attend for non-urgent conditions. The objective of this paper is to compare and contrast administrative data with the views of hospital staff and older people with regard to their presentation at two emergency departments in metropolitan Adelaide and how this aligns with the Australian Institute of Health and Welfare definition of 'potentially avoidable general practitioner-type presentations.'Methods. The study used three sources of data from two emergency departments: hospital data for the financial year 2010-11 for patients aged 65 years and over and identified as triage category four or five; three focus groups with medical, nursing and allied staff from these two hospitals; and interviews with 58 older people who presented at the two emergency departments over a two-week period.Results. The hospital administrative data provided a very limited insight into why older people attended the emergency department, other than the medical diagnosis. Professional staff identified individual determinants, societal determinants and the health services system as explanations. Older people attended the emergency department for a range of reasons that may not necessarily reflect the opinions of health professionals.Conclusions. For many older people the emergency department was an appropriate place to attend considering their condition, though some presentations could be circumvented with appropriate and increased services in the community. However, as many older people suffer comorbidities, careful consideration needs to be given as to the best possible practices to achieve this.What is known about the topic? Increasing demands are being placed on hospital emergency departments and there are concerns that a growing number of presentations are 'inappropriate presentations'. Older people are considered to be one group that overuse emergency department services. What does this paper add? Most studies use hospital statistics to examine primary care presentations at emergency departments or present the viewpoints of medical staff within hospitals about the necessity of these visits. This paper compares and contrasts the available data from hospitals, the opinions of medical and allied health professionals and information collected from older people themselves to provide greater insight into why older people triaged as three, four or five attend emergency departments in Adelaide. What are the implications for practitioners? For a range of reasons including availability of quality care, familiarity with hospital services, and a lack of community based services, older people will continue to present to emergency departments. With increasing numbers of older people in the population, hospital emergency departments will need to continuously adapt to accommodate the needs of this older demographic and for staff to acquire necessary geriatric skills.Additional...

show abstract

mentioning

confidence: 99%

The ‘unnecessary’ use of emergency departments by older people: findings from hospital data, hospital staff and older people

Faulkner

Law

2015

Aust. Health Review

View full text Add to dashboard Cite

show abstract

“…The second data source is a survey of patients conducted in 2004, described in detail elsewhere. 14 Patients completed the survey in the Emergency Departments of the Illawarra region of NSW at the time of presentation. The survey included five EDs representing all levels of facility within the state from rural, GP-run service through to major regional referral.…”

Section: Methodsmentioning

confidence: 99%

“…12,13 A recent study focussed on the reasons that "potential primary care" (PPC) patients give for presenting to EDs rather than to general practitioners. 14 The main finding was that patients identified "very appropriate and sensible reasons for coming to the ED -urgency, complexity and being able to have the diagnostic tests they had anticipated would be required". It was argued that improvements to GP affordability and availability would hence be unlikely to affect the numbers of such attendances in a large way.…”

mentioning

confidence: 99%

Primary care presentations at emergency departments: rates and reasons by age and sex

Siminski¹,

Bezzina²,

Lago³

et al. 2008

Aust. Health Review

Self Cite

View full text Add to dashboard Cite

Primary care presentations at emergency departments (EDs) have been the subject of much attention in recent years. This paper is a demographic analysis using administrative data from the Emergency Department Information System (EDIS) for 2005 of such presentations in New South Wales EDs and of self-reported reasons for presentation. Age and sex differences in the reasons given by patients for such presentations are analysed using data from a survey of patients conducted in a subset of EDs in 2004.

show abstract

“…Patients can only be expected to act on their own judgement. 2 Use of the ED is for most people an affirmative choice over other providers, rather than a last resort, and it is often a choice driven by lack of access or dissatisfaction with other providers.…”

Section: Primary Care Patients' Reasons For Choosing Emergency Departmentioning

confidence: 99%

“…The BJGP in December has the reference to chronic in the title of four of its articles. [1][2][3][4] Language changes with time and with usage. For example, the phrase 'terminal care' has made a transition to the more positivesounding 'palliative care', not least because we are far more open in our discussions with patients than we were a generation or two ago and need to be sensitive to their interpretation of our terminology.…”

mentioning

confidence: 99%

We need another word for ‘chronic’

Charlton

2014

Br J Gen Pract

View full text Add to dashboard Cite

Primary care patients' views on why they present to Emergency Departments: Inappropriate attendances or inappropriate policy?

Cited by 21 publications

References 0 publications

The ‘unnecessary’ use of emergency departments by older people: findings from hospital data, hospital staff and older people

The ‘unnecessary’ use of emergency departments by older people: findings from hospital data, hospital staff and older people

Primary care presentations at emergency departments: rates and reasons by age and sex

We need another word for ‘chronic’

Contact Info

Product

Resources

About