Objective: To model the effectiveness of afterhours general practice (GP) in reducing metropolitan Perth emergency departments' (ED) low acuity patient (LAP) attendances and costs. Methods:We estimated LAP attendances by comparison of the product of (A) the difference between self-referred and GP-referred ED discharge rates and (B) total self-referred attendances (LAP attendances = A B). We then compared after-hours ED LAP attendance rates and costs with inner metropolitan "working-week" ED LAP attendance rates and costs, when GP services are maximally available.Results: Working-week LAP attendances comprised 8.2% (95% CI, 8.0%-8.4%) of inner metropolitan ED attendances. Excess weekend and evening LAP attendances were estimated to comprise 16.5% (95%CI, 15.9%-17.0%) and 4.5% (95%CI, 4.1%-4.9%) of outer and inner metropolitan ED attendances respectively and totalled less than 3.0% of ED costs. Conclusions:Low acuity patients form a relatively constant, inexpensive proportion of ED workloads. After-hours GP LAP services are unlikely to

Paired cardiac markers performed adequately for avoidable MACE, and disposition improved significantly. A confounding system change meant the reduced EDLOS (primary outcome) was unable to be associated with the intervention.

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