After-hours general practice clinics are unlikely to reduce low acuity patient attendances to metropolitan Perth emergency departments.
OBJECTIVE
To model the effectiveness of after-hours 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 x 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 significantly reduce ED attendances or costs.
Nagree
Yusuf
Y
Emergency Department, Armadale Health Service, Armadale, WA.
Ercleve
Tor N O
TN
Sprivulis
Peter C
PC
D000208:Acute Disease; D039602:After-Hours Care / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014218:Triage; D014904:Western Australia; D016526:Workload