The effect of a general practice after-hours clinic on emergency department presentations: a regression time series analysis.
OBJECTIVE
To assess the impact of the opening of an after-hours general practice clinic on the number of daily low-urgency presentations to the nearby emergency department.


METHODS
Retrospective time series analysis of emergency presentation data, from the New South Wales Health Emergency Department Information System, for all patients presenting to the emergency department of Wagga Wagga Base Hospital between January 1998 and October 2008.


METHODS
Daily emergency department presentations, before and after the March 2003 opening of the after-hours clinic, of patients triaged as Australasian Triage Scale (ATS) category 4 or 5 (at any time of day, and during the hours of operation of the clinic), and of patients triaged as ATS category 1, 2 or 3 (at any time of day).


RESULTS
After adjusting for long-term trends and weekly and annual cycles, the opening of the after-hours clinic was associated with a daily reduction of 7.04 patients (95% CI, 5.39-8.70) in emergency department presentations with an ATS category of 4 or 5. This represented an 8.2% reduction in total presentations (95% CI, 6.2%-10.2%). Presentations of ATS category 1, 2 or 3 patients rose by 1.36 patients a day (95% CI, 0.36-2.35), representing 1.6% of total presentations (95% CI, 0.4%-2.7%). The impact of the after-hours clinic was best modelled by a gradual permanent change.


CONCLUSIONS
An after-hours general practice clinic was associated with a reduction in low-urgency presentations to the emergency department in Wagga Wagga.
Buckley
David J
DJ
Greater Southern Area Health Service, Wagga Wagga, NSW, Australia. david.buckley@gsahs.health.nsw.gov.au
Curtis
Paul W
PW
McGirr
Joseph G
JG
D039602:After-Hours Care / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D009517:New South Wales / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D014218:Triage / Q000706:statistics & numerical data*