title: How have changes to out-of-hours primary care services since 2004 affected emergency department attendances at a UK District General Hospital? A longitudinal study.
abstract: BACKGROUND
  The delivery of out-of-hours primary medical care in the United Kingdom has changed substantially since 2004, and there has been little examination of the effect that this has on secondary care.
  
  
  OBJECTIVE
  The authors aimed to quantify the change in patient type presenting to our emergency department.
  
  
  METHODS
  In this study, routinely collected coding data before, during and after the changes were analysed. Each September and October between 1999 and 2006 were included.
  
  
  RESULTS
  There was a steady increase in all attendances at our emergency department. The number and proportions of patients with non-traumatic conditions rose steadily throughout the study period. The number of patients presenting with traumatic conditions stayed the same. The number of patients presenting with non-traumatic conditions out-of-hours rose after the changes were implemented.
  
  
  CONCLUSIONS
  The changes to the provision of out-of-hours primary care have been associated with an increase in patients with non-traumatic attendances presenting to our emergency department. This effect is most marked outside of office hours.
authors.affiliation: Peterborough District Hospital, Peterborough PE3 6DA, UK. catriona.thompson@pbh-tr.nhs.uk
authors.forename: C
authors.initials: C
authors.lastname: Thompson
authors.forename: C
authors.initials: C
authors.lastname: Hayhurst
authors.forename: A
authors.initials: A
authors.lastname: Boyle
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006769:Hospitals, General; D006801:Humans; D008137:Longitudinal Studies; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D006113:United Kingdom