title: Impact of a GP cooperative on lower acuity emergency department attendances.
abstract: BACKGROUND
  In 1998 'Dubdoc', Ireland's first out-of-hours general practice emergency service, opened in an outpatient suite in St James's Hospital with a separate entrance 300 m from the emergency department (ED). Dubdoc was established with the aim of providing an easy access out-of-hours service for ambulatory patients of those doctors supplying the service.
  
  
  OBJECTIVE
  To determine whether ED attendances for patients in the lower acuity triage categories 4 and 5 have changed since the establishment of 'Dubdoc'.
  
  
  METHODS
  A retrospective review of all attendances at the 'Dubdoc' service was compared with attendances at the ED for triage categories 4 and 5 of the same hospital over a 9-year period (1999-2007 inclusive) for equivalent times of day.
  
  
  RESULTS
  ED attendances during 'Dubdoc' hours have decreased as a proportion of all attendances for triage categories 4 and 5. ED attendances for triage categories 4 and 5 fell substantially during the study period.
  
  
  CONCLUSIONS
  Although the presence of the 'Dubdoc' service has resulted in a decrease in ED attendances for triage categories 4 and 5, this is a minor proportion of the overall decrease in attendances in this group of patients.
authors.affiliation: Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland. feokelly@tcd.ie
authors.forename: Fergus D
authors.initials: FD
authors.lastname: O'Kelly
authors.forename: Conor
authors.initials: C
authors.lastname: Teljeur
authors.forename: Ian
authors.initials: I
authors.lastname: Carter
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Plunkett
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D002391:Catchment Area, Health; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D058006:General Practice / Q000458:organization & administration*; D006801:Humans; D007494:Ireland; D011365:Professional Practice Location; D012189:Retrospective Studies; D014218:Triage / Q000145:classification