Why patients attend after-hours medical services: a cross-sectional survey of patients across the Australian Capital Territory
Katelyn Barnes A B * , Dagmar Ceramidas A B and Kirsty Douglas A BA Academic Unit of General Practice, Office of Professional Leadership and Education, ACT Health Directorate, Canberra, ACT, Australia.
B Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
Australian Journal of Primary Health 28(6) 549-555 https://doi.org/10.1071/PY22087
Submitted: 22 April 2022 Accepted: 1 August 2022 Published: 31 August 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC)
Abstract
Background: Almost half of Australian after-hours emergency department (ED) presentations are rated as ‘non-urgent’ by clinicians and are suggested to be managed by community-based services, such as general practice (GP). This paper reports patient reasons for presenting for medical care after hours, and reasons for selection of specific services across a health system.
Methods: A cross-sectional survey was conducted across the Australian Capital Territory. Patients voluntarily completed questionnaires in waiting rooms during the after-hours periods of one weekday and one weekend in 2019 at 28/51 extended hours GPs, 3/3 medical deputising services (MDS), 3/3 nurse-led walk-in-clinics (WICs), and 2/2 public emergency departments (EDs).
Results: Of 3371 presentations, 1992 patients completed a survey, with 58% from GPs (n = 1149), 16% from WIC (n = 317), 10% from MDS (n = 193), and 17% from EDs (n = 333). Most patients presented with self-rated new issues (n = 987, 49.5%) and were uncertain of the urgency of their issues (n = 723, 36.7%). Common reasons for presenting to WIC, MDS, and EDs included the problem occurring after hours, and patients concern about the issue. Common reasons for presenting to GP were related to personal preference for after-hours care.
Conclusions: Patients present to after-hours medical services for both perceived need and convenience. Most patients appear to be self-selecting after-hours services appropriately aligned with advertised services; except for GP patients who were attending after hours for care that is often non-urgent and could be seen in usual working hours. This study should be replicated to account for local health systems, and coronavirus disease 2019 (COVID-19)-related changes to health care.
Keywords: after-hours care, emergency department, general practice, health-seeking behaviour, health services research, health systems, primary care, survey.
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