title: General practitioners' assessments of the primary care caseload in Middlemore Hospital Emergency Department.
abstract: OBJECTIVE
  To estimate the proportion of Middlemore Hospital Emergency Department (ED) attendances that GPs thought could be handled in primary care.
  
  
  METHODS
  A retrospective review of 300 randomly selected discharge summaries of non-admitted patients by 12 GPs.
  
  
  RESULTS
  Data were available from 278 discharges. Agreement between GP reviewers was "fair" (kappa = 0.34, Kendall's W = 0.48). In 50 cases, the GPs were unanimous that the case was a primary care case (18%). In two cases, there was unanimity that the case was an ED case (<1%). The 12 GPs assessed that an average of 56% (range 38-81%) of the cases they reviewed could have been handled in their surgeries yesterday with no extra resources. This suggests that 34% of the total ED caseload (ie, including admitted patients) could be managed in primary care.
  
  
  CONCLUSIONS
  A significant proportion of ED attendances at Middlemore Hospital could be handled in primary care; however, there is considerable variation in GP estimates of this proportion.
authors.affiliation: Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. barry.gribben@cbg.co.nz
authors.forename: Barry
authors.initials: B
authors.lastname: Gribben
mesh_terms: D000293:Adolescent; D000328:Adult; D019090:Case Management / Q000145:classification / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011897:Random Allocation; D012189:Retrospective Studies