After-hours general practice clinics are unlikely to reduce low acuity patient attendances to metropolitan Perth emergency departments

Abstract

Objective: To model the effectiveness of afterhours general practice (GP) in reducing metropolitan Perth emergency departments? (ED) low acuity patient (LAP) attendances and costs. Methods: We estimated LAP attendances by comparison of the product of (A) the difference between self-referred and GP-referred ED discharge rates and (B) total self-referred attendances (LAP attendances = A - B). We then compared after-hours ED LAP attendance rates and costs with inner metropolitan 'working-week' ED LAP attendance rates and costs, when GP services are maximally available. Results: Working-week LAP attendances comprised 8.2% (95% CI, 8.0%?8.4%) of inner metropolitan ED attendances. Excess weekend and evening LAP attendances were estimated to comprise 16.5% (95%CI, 15.9%?17.0%) and 4.5% (95%CI, 4.1%?4.9%) of outer and inner metropolitan ED attendances respectively and totalled less than 3.0% of ED costs. Conclusions: Low acuity patients form a relatively constant, inexpensive proportion of ED workloads. After-hours GP LAP services are unlikely to significantly reduce ED attendances or costs.