title: Transfers from residential aged care facilities to the emergency department are reduced through improved primary care services: an intervention study.
abstract: OBJECTIVE
  To assess the impact of an enhanced primary care service for residential aged care facilities (RACF) on the transfer of patients from RACF to a hospital emergency department (ED).
  
  
  METHODS
  A before-after study of an enhanced primary care service provided by experienced ED-based nurses under the governance of general practitioners. The intervention was analysed comparatively using standardised normal deviates and seasonal autoregressive integrated moving average models, complemented by qualitative assessment.
  
  
  RESULTS
  There was a statistically significant reduction (17%, P < 0.001) in the number of transfers during the intervention period. This finding held when adjusting for the seasonality of ED referrals over a 4-year period. The intervention was highly valued by clinicians in RACF and ED.
  
  
  CONCLUSIONS
  Enhanced primary care services reduce the number of transfers to ED from RACF.
authors.affiliation: South Metropolitan Area Health Service, Perth, Western Australia, Australia.
authors.forename: Jim
authors.initials: J
authors.lastname: Codde
authors.forename: Glenn
authors.initials: G
authors.lastname: Arendts
authors.forename: Jackie
authors.initials: J
authors.lastname: Frankel
authors.forename: Mary
authors.initials: M
authors.lastname: Ivey
authors.forename: Tracy
authors.initials: T
authors.lastname: Reibel
authors.forename: Shirley
authors.initials: S
authors.lastname: Bowen
authors.forename: Paul
authors.initials: P
authors.lastname: Babich
mesh_terms: D000368:Aged; D004636:Emergency Service, Hospital; D006299:Health Services for the Aged; D006801:Humans; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012112:Residential Facilities