title: Primary care or A&E? A study of patients redirected from an accident & emergency department.
abstract: A departmental policy was introduced whereby patients with a complaint of over three days duration are assessed at triage by senior doctors as to whether they should be seen in A&E or redirected to primary care. This pilot study aimed to establish numbers, demographics, reasons for attending and outcome. A total of 179 patients were studied. Most were young men attending during working hours on week days. Most had symptoms for more than one week and had not seen their GP. Of 137 patients advised to see their GP--67 did so. No adverse outcomes were reported. Twenty-three patients were seen in A&E: six had fractures, one required admission. Limited resources and increasing demands means that A&E must define its service. This system selects out those patients with prolonged symptoms who are likely to be able to be managed in the primary care setting.
authors.affiliation: Accident & Emergency Department, Ninewells Hospital, Dundee, DD1 9SY.
authors.forename: E A
authors.initials: EA
authors.lastname: McGugan
authors.forename: W
authors.initials: W
authors.lastname: Morrison
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D015276:Health Care Rationing; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006302:Health Services Research; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D016134:Organizational Policy; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010865:Pilot Projects; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000458:organization & administration*; D012606:Scotland; D013997:Time Factors; D014218:Triage / Q000458:organization & administration*