O'Loughlin, Mary, Mills, Jane, McDermott, Robyn, and Harriss, Linton R. (2020) Exploring the measure of potentially avoidable general practitioner-type presentations to the emergency department in regional Queensland using linked, patient-perspective data. Australian Health Review, 45 (1). pp. 90-96.

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Abstract

Objective. To explore measures of potentially avoidable general practitioner (PAGP)-type presentations to the emergency department (ED) of a large regional hospital in northern Queensland.

Methods. Linkage of an ED administrative dataset to a face-to-face patient survey of local residents (n = 1000); calculation of Australian Institute of Health and Welfare (AIHW) and Australasian College of Emergency Medicine (ACEM) measures of PAGP-type presentations to the ED; and exploration of these measures with patient-perspective linked data.

Results. PAGP-type presenters to the ED were younger in age (median age in years: total cohort: 49; AIHW 38, P , 0.001; ACEM 36, P , 0.001); with the odds of having a chronic condition being less likely for AIHW PAGP-type presenters than other ED presenters (OR (95% CI) 0.54 (0.38–0.77): P = 0.001)) after adjustment for age. PAGP-type presenters nominated reasons of convenience rather than urgency as their rationale for attending the ED, irrespective of measure. The number of PAGP-type presentations to the ED identified by the AIHW measure was more than three-fold higher than the ACEM measure (AIHW: n = 227; ACEM: n = 67). Influencing factors include the low proportion of ED attendees who had a medical consultation time of ,1 h at this hospital site (1-month survey period: 17.8%); and differences between the patient self-report and ED administrative record for 'self-referral to the ED' (Self-referred: Survey 71% vs EDIS 93%, P , 0.001).

Conclusions. Identification of PAGP-type presentations to the ED could be enhanced with improvements to the quality of administrative processes when recording patient 'self-referral to the ED', along with further consideration of hospital site variation for the length of medical consultation time.

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