Comparison of methods used to quantify general practice‐type patients in the emergency department: A tertiary paediatric perspective. (29th September 2016)

• Record Type: Journal Article
• Authors: Borland, Meredith; Skarin, Dmitry; Nagree, Yusuf
• Is Part Of: Emergency medicine Australasia. Volume 29:Number 1(2017:Feb.)
• Page Start: 77
• Page End: 82
• Publication Date: 2016-09-29
• Subjects: Australasian College for Emergency Medicine -- Australian Institute of Health and Welfare -- diagnosis -- emergency department -- general practice type -- paediatric; Emergency medicine -- Periodicals; Emergency medicine -- Australasia -- Periodicals; 616.025
• DOI: 10.1111/1742-6723.12683
• Languages: English
• ISSNs: 1742-6731

Abstract

Abstract: Objective: The aim of this study was to compare methods for quantifying general practice‐type (GP‐type) patients in a paediatric ED to determine the robustness of current identification methods. Methods: Data was sourced from the ED Information System for 5 years (2010–2014) from the tertiary paediatric hospital in Perth, Western Australia, Australia. A further detailed analysis of 2014 presentations established an independent sample for valid statistical comparison of the three methods used to identify GP‐type patients: Australian Institute of Health and Welfare, ACEM and the Diagnosis. Results: A total of 348 020 patients presented in 2010–2014, with the percentage of GP‐type patients identified varying from 38% to 68% by the three methods. Fewer GP‐type presentations occurred over each consecutive year and had significantly lower median medical consultation times and ED length of stay when compared with the total presentation sample. GP‐type presentations were evenly spread across the days and times of the week, with ACEM demonstrating only fewer presentations during office hours ( P = 0.02). In 2014 there was only overlap in 36.6% cases for all three methods – 6.9% exclusively flagged by ACEM, 22.7% by Australian Institute of Health and Welfare and 0.2% by the Diagnosis method. Conclusions: We demonstrated that current models to quantify perceived GP‐type presentations were inconsistent in paediatric patients. All methods flagged a high proportion of GP‐type presentations, and although the reasons for these presentations are multifactorial and not easily explained by access to GP services alone, they do represent a significant workload in the paediatric ED.