The ED2GP (emergency department to general practice) for Women study: understanding lower follow-up rates among older women
Shaddy Hanna
A , Chun Wah Michael Tam B C F , Andrew Knight B C , Linheng Zhao A , Lucille Ban D , Belinda Pellizzon D and James Parks E
A UNSW Medicine, Wallace Wurth Building, 18 High Street, Kensington, NSW 2052, Australia.
B Primary and Integrated Care Unit, South Western Sydney Local Health District, PO Box 215, Villawood, NSW 2163, Australia.
C School of Population Health, Samuels Building, UNSW Sydney, NSW 2052, Australia.
D Emergency Department, Fairfield Hospital, South Western Sydney Local Health District, Prairievale Road and Polding Street, Prairiewood, NSW 2176, Australia.
E School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
F Corresponding author. Email: m.tam@unsw.edu.au
Australian Journal of Primary Health 26(5) 396-401 https://doi.org/10.1071/PY19221
Submitted: 12 November 2019 Accepted: 24 August 2020 Published: 28 September 2020
Journal Compilation © La Trobe University 2020 Open Access CC BY-NC-ND
Abstract
Older women seem to have lower GP follow-up rates after an emergency department (ED) discharge than men. This qualitative study investigated how older women seek GP follow up after an ED visit. In 2018, women aged ≥65 years were recruited from an ED in a suburban hospital in south-western Sydney, Australia, and then contacted 1 week later for a telephone interview exploring factors associated with their follow-up behaviour. Grounded theory was used to construct a potential explanatory model of follow-up behaviours. Of the 100 women recruited, 64% had attended a GP follow up by Day 7, as instructed. The balance of perceived cost and benefit of GP follow up emerged as a useful model to understand the factors affecting follow-up behaviour. Perceived costs included inconvenience caused to self and others, access to transport options and the availability of a patient’s GP. Perceived benefits included previous experiences with the healthcare system, pre-existing health-seeking behaviours and ED messaging. Our findings suggest that follow-up rates could be improved by strengthening the perceived benefit of GP follow up at the point of ED discharge, in addition to addressing perceived costs. Approaches may include ensuring discharge instructions are purposeful and given in the company of an older woman’s social supports.
Keywords: community health care, delivery of health care: integrated, emergency medical services, health behaviour, health transition.
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