General practitioner-type patients in emergency departments in metro North Brisbane, Queensland: A multisite study

Ghasem Toloo, Nimisha Bahl, David Lim, Gerry FitzGerald, Darren Wraith, Kevin Chu, Frances B. Kinnear, Peter Aitken, Douglas Morel

Research output: Contribution to journalArticle

Abstract

Objective: To estimate the proportion of ED patients in urban Queensland who are potentially suitable for general practitioner (GP) care. Methods: A retrospective analysis was conducted using ED Information System data from Metro North Hospital and Health Service in Brisbane, Australia for three consecutive financial years (2014–2015 to 2016–2017). The hospitals included two Principal Referral and two Public Acute hospitals. GP-type patients were calculated using the Australian Institute of Health and Welfare (AIHW), Australasian College for Emergency Medicine (ACEM) and the validated Sprivulis methods. Results: Of the 822 841 ED presentations, 219 567 (27%) were potentially GP-type patients by AIHW, 49 307 (6%) by ACEM and 61 836 (8%) by Sprivulis methods. The higher proportion of GP-type presentations were during 08.00 to 17.00 hours by AIHW and ACEM methods. Of the lower-acuity triage categories of 4 (286 154 presentations) and 5 (5658 presentations), AIHW estimated that 62% and 80% of the patients were GP-type patients, as compared to 9% and 22% by ACEM, and 9% and 0.3% by Sprivulis method. The mean costs of adult GP-type patients is $345 by the AIHW and $406 by the ACEM method, lower than non-GP type patients ($706 and $622, respectively). Conclusions: There is considerable variation in what is considered GP-type ED presentations based on the three methods employed and this variation may have fuelled the debate surrounding what is ‘avoidable’ ED utilisation. Regardless, the study findings provide an interesting addition to defining and addressing appropriate utilisation of ED services.

Original languageEnglish
Pages (from-to)481-488
Number of pages8
JournalEMA - Emergency Medicine Australasia
Volume32
Issue number3
DOIs
Publication statusPublished - 1 Jun 2020
Externally publishedYes

Keywords

  • avoidable ED utilisation
  • emergency departments
  • general practice
  • health services needs and demand
  • healthcare costs

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