Primary care services and emergency medicine

Quantifying the proportion of general practice and low‐acuity patients in the emergency department

“…7 After-hours GP clinics, super clinics and polyclinics may fill gaps in medical services but have minimal effects on ED attendances. 9,[14][15][16][17][18][19] The impact on the ED from diverting general practicetype patients is low, and inaccurate reporting of the true proportion of these patients results in policy and program initiatives that do not address the real cause of ED overcrowding, which is the lack of available inpatient beds. 20 Evidence consistently demonstrates that overcrowding leads to increased patient mortality, morbidity and prolonged hospital stays.…”

Telephone triage is not the answer to ED overcrowding

“…Access block, not low‐acuity patients, is the key driver of ED overcrowding, staff stress, patient distress and increased mortality and morbidity 12,13,35 . Access block occurs when patients who have received their emergency care and need a hospital bed remain in the ED because no beds are available in the hospital 38 .…”

“…A number of interrelated factors are postulated to drive this growth in demand and cause increased ED overcrowding. 12 Unfortunately, an enduring myth is that EDs are overrun with patients who could have received care in a general practice setting, [12][13][14][15] and policies have been made based on this invalid assumption. Such policy initiatives have included stand-alone GP casualties, co-located GP clinics with EDs, GP Super Clinics and nurse walk-in-centres co-located with an ED.…”

“…15 Access block, not low-acuity patients, is the key driver of ED overcrowding, staff stress, patient distress and increased mortality and morbidity. 12,13,35 Access block occurs when patients who have received their emergency care and need a hospital bed remain in the ED because no beds are available in the hospital. 38 Lowacuity patients do not contribute to access block as generally they require only a small amount of time to be examined and treated in the ED and are rarely admitted.…”

Primary care services and emergency medicine

“…T o the Editor: I agree with the claim by Richardson that “the overlap between [primary care and emergency department (ED)] services is not as important as many have claimed” and that “‘primary care patients’ and ‘ED [Australasian Triage Scale] category 4 and 5’ patients are not interchangeable” 1 . A review of the literature — especially from New Zealand — would show there are considerable differences between patients who attend the two types of services.…”