Comparison of methods used to quantify general practice-type patients in the emergency department: A tertiary paediatric perspective.
OBJECTIVE
The aim of this study was to compare methods for quantifying general practice-type (GP-type) patients in a paediatric ED to determine the robustness of current identification methods.


METHODS
Data was sourced from the ED Information System for 5 years (2010-2014) from the tertiary paediatric hospital in Perth, Western Australia, Australia. A further detailed analysis of 2014 presentations established an independent sample for valid statistical comparison of the three methods used to identify GP-type patients: Australian Institute of Health and Welfare, ACEM and the Diagnosis.


RESULTS
A total of 348 020 patients presented in 2010-2014, with the percentage of GP-type patients identified varying from 38% to 68% by the three methods. Fewer GP-type presentations occurred over each consecutive year and had significantly lower median medical consultation times and ED length of stay when compared with the total presentation sample. GP-type presentations were evenly spread across the days and times of the week, with ACEM demonstrating only fewer presentations during office hours (P = 0.02). In 2014 there was only overlap in 36.6% cases for all three methods - 6.9% exclusively flagged by ACEM, 22.7% by Australian Institute of Health and Welfare and 0.2% by the Diagnosis method.


CONCLUSIONS
We demonstrated that current models to quantify perceived GP-type presentations were inconsistent in paediatric patients. All methods flagged a high proportion of GP-type presentations, and although the reasons for these presentations are multifactorial and not easily explained by access to GP services alone, they do represent a significant workload in the paediatric ED.
Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia.|School of Paediatric and Child Health, The University of Western Australia, Perth, Western Australia, Australia.|School of Primary, Aboriginal and Rural Healthcare, The University of Western Australia, Perth, Western Australia, Australia.
Meredith
M
Borland
Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia.
Dmitry
D
Skarin
School of Primary, Aboriginal and Rural Healthcare, The University of Western Australia, Perth, Western Australia, Australia.|Emergency Department, Fiona Stanley Hospital, Perth, Western Australia, Australia.
Yusuf
Y
Nagree
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003441:Crowding; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D010361:Patients / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014904:Western Australia
Australasian College for Emergency Medicine; Australian Institute of Health and Welfare; diagnosis; emergency department; general practice type; paediatric