Do access, quality and cost of general practice affect emergency department use?

Pak, Anton, and Gannon, Brenda (2021) Do access, quality and cost of general practice affect emergency department use? Health Policy, 125 (4). pp. 504-511.

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Limited access, poor experience, and high out-of-pocket (OOP) costs of primary care services may lead to avoidable emergency department (ED) presentations. But, the evidence has been limited with most of the studies using surveys conducted in EDs. Using detailed health survey data of Australian women linked to multiple administrative datasets, we extend the literature by estimating the effects of access, costs, and experience of general practice (GP) services on the probability of ED attendance while accounting for a large set of health and socioeconomic covariates. Our findings suggest that improvements in access to primary care services can significantly reduce the demand for low acuity ED presentations. We also show that the impact of increased accessibility of GP services is expected to be the highest for socioeconomic vulnerable populations and patients whose access is the poorest. This evidence can be useful for the design of targeted policies aimed at improving access to doctors in particular areas that are socioeconomically disadvantaged and where medical skill shortages are significant. However, policies aimed at reduction in primary care OOP costs or improvement in the perception of GP quality are less likely to be effective in reducing the number of non-urgent ED presentations.

Item ID: 67449
Item Type: Article (Research - C1)
ISSN: 1872-6054
Copyright Information: © 2021. Elsevier. B.V. All rights reserved.
Funders: Australian Government Research Training Program, Department of Health
Date Deposited: 17 Jun 2021 00:46
FoR Codes: 38 ECONOMICS > 3801 Applied economics > 380108 Health economics @ 40%
42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 20%
44 HUMAN SOCIETY > 4407 Policy and administration > 440706 Health policy @ 40%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200401 Behaviour and health @ 50%
15 ECONOMIC FRAMEWORK > 1505 Microeconomics > 150509 Preference, behaviour and welfare @ 50%
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