Primary care in accident and emergency and general practice: a comparison.
This paper reviews the way in which literature describing 'inappropriate' attenders at Accident and Emergency (A & E) departments in Britain has suggested that they could be provided for in General Practice and that their attendance at A & E departments therefore implies a 'failure' of general practice in urban areas. One problem with much previous research is that 'inappropriate' attenders have been retrospectively identified. The comparative survey of attenders at a London A & E department and patients visiting their GP in the same district reported here prospectively identified A & E attenders with primary care problems and examined the differences between them and the GP attenders. Patients attending the hospital A & E department were similar to the GP attenders in terms of socio-economic indicators, but had problems which were not typical of the general practice workload and were in different circumstances. The results suggest that there will be a continuing demand for hospital-provided primary care in urban areas, and that attempts to deflect such care to the community will meet with limited success.
Green
J
J
Department of General Practice and Primary Care, King's College School of Medicine and Dentistry, London, U.K.
Dale
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005194:Family Practice / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006302:Health Services Research; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008131:London; D008297:Male; D008875:Middle Aged; D009790:Occupations; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D014218:Triage; D014850:Waiting Lists