Emergency medicine and "acute" general practice: comparing apples with 0ranges

Ieraci, Sue; Cunningham, Peter; Talbot-Stern, Janet; Walker, Susan

doi:10.1071/ah000152

Cited by 27 publications

(19 citation statements)

References 1 publication

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“…Formal studies to determine the effects of such initiatives are rare, although a recent review found that there was no evidence that they reduced ED demand 21 . The GP casualty model has been clearly disproven as an alternative to properly set up EDs 22 . An analysis by Richardson 23 showed that the introduction of a Canberra nurse walk‐in‐centre led to an increase in patient attendances at the co‐located ED.…”

mentioning

confidence: 99%

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Telephone triage is not the answer to ED overcrowding

Nagree

Cameron

Gosbell

et al. 2012

Emerg Medicine Australasia

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mentioning

confidence: 99%

“…21 The GP casualty model has been clearly disproven as an alternative to properly set up EDs. 22 An analysis by Richardson 23 showed that the introduction of a Canberra nurse walkin-centre led to an increase in patient attendances at the co-located ED. After a year of operation, still no decrease was seen in ED attendances.…”

mentioning

confidence: 99%

Telephone triage is not the answer to ED overcrowding

Nagree

Cameron

Gosbell

et al. 2012

Emerg Medicine Australasia

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“…After-hours general practice clinics have been trialled adjacent to a number of metropolitan emergency departments (Ieraci et al 2000;Ruffin & Hooper 2003;Bolton & Thompson 2001;Liaw et al 2001). There may be a prima facie case for their operation as a means of extending the available hours of access for patients seeking greater flexibility in access to primary care services (Liaw 2001).…”

Section: What Are the Implications?mentioning

confidence: 99%

After-hours general practice clinics are unlikely to reduce low acuity patient attendances to metropolitan Perth emergency departments

Nagree¹,

Ercleve²,

Sprivulis³

2004

Aust. Health Review

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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

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“…3 Many health services are working to have a general practice clinic in or near public hospitals. Literature on the quantitative effect of general practice clinics is equivocal, [4][5][6][7][8][9][10][11][12][13] particularly in Australia.…”

mentioning

confidence: 99%

The effect of a general practice after‐hours clinic on emergency department presentations: a regression time series analysis

Buckley

Curtis

McGirr

2010

Medical Journal of Australia

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Objective: To assess the impact of the opening of an after‐hours general practice clinic on the number of daily low‐urgency presentations to the nearby emergency department. Design, participants and setting: Retrospective time series analysis of emergency presentation data, from the New South Wales Health Emergency Department Information System, for all patients presenting to the emergency department of Wagga Wagga Base Hospital between January 1998 and October 2008. Main outcome measures: Daily emergency department presentations, before and after the March 2003 opening of the after‐hours clinic, of patients triaged as Australasian Triage Scale (ATS) category 4 or 5 (at any time of day, and during the hours of operation of the clinic), and of patients triaged as ATS category 1, 2 or 3 (at any time of day). Results: After adjusting for long‐term trends and weekly and annual cycles, the opening of the after‐hours clinic was associated with a daily reduction of 7.04 patients (95% CI, 5.39–8.70) in emergency department presentations with an ATS category of 4 or 5. This represented an 8.2% reduction in total presentations (95% CI, 6.2%–10.2%). Presentations of ATS category 1, 2 or 3 patients rose by 1.36 patients a day (95% CI, 0.36–2.35), representing 1.6% of total presentations (95% CI, 0.4%–2.7%). The impact of the after‐hours clinic was best modelled by a gradual permanent change. Conclusion: An after‐hours general practice clinic was associated with a reduction in low‐urgency presentations to the emergency department in Wagga Wagga.

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Emergency medicine and "acute" general practice: comparing apples with 0ranges

Cited by 27 publications

References 1 publication

Telephone triage is not the answer to ED overcrowding

Telephone triage is not the answer to ED overcrowding

After-hours general practice clinics are unlikely to reduce low acuity patient attendances to metropolitan Perth emergency departments

The effect of a general practice after‐hours clinic on emergency department presentations: a regression time series analysis

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