Potential role of general practice in reducing emergency department demand: A qualitative study.

Willson, KA; Lim, D; Toloo, G-S; FitzGerald, G; Kinnear, FB; Morel, DG

Potential role of general practice in reducing emergency department demand: A qualitative study.

Willson, KA Lim, D Toloo, G-S FitzGerald, G Kinnear, FB Morel, DG

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Emerg Med Australas, 2022, 34, (5), pp. 717-724
Issue Date:: 2022-10

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Field	Value	Language
dc.contributor.author	Willson, KA
dc.contributor.author	Lim, D
dc.contributor.author	Toloo, G-S
dc.contributor.author	FitzGerald, G
dc.contributor.author	Kinnear, FB
dc.contributor.author	Morel, DG
dc.date.accessioned	2023-07-17T05:03:02Z
dc.date.available	2022-02-28
dc.date.available	2023-07-17T05:03:02Z
dc.date.issued	2022-10
dc.identifier.citation	Emerg Med Australas, 2022, 34, (5), pp. 717-724
dc.identifier.issn	1742-6731
dc.identifier.issn	1742-6723
dc.identifier.uri	http://hdl.handle.net/10453/171555
dc.description.abstract	OBJECTIVE: To inform local, state and national strategies intended to reduce demand for ED care, the present study aimed to identify key factors influencing the current provision of acute care within primary healthcare (PHC) and explore the policy and system changes potentially required. METHODS: Semi-structured interviews with key stakeholders were audio-recorded, transcribed verbatim and analysed through content and thematic approaches incorporating the Walt and Gilson health policy framework. RESULTS: Eleven interviews were conducted. Five key considerations were highlighted, namely the barriers and enablers for general practitioners (GPs) in providing acute care, barriers to patient use of PHC instead of ED, suggestions for new PHC models and improvements for current ED models. Additionally, economic issues relating to clinic funding and GP remuneration, complexities of state or federal funding and management of urgent care centres (UCC) were identified. Potential policy changes included GP clinics incorporating emergency appointments, GP triage, further patient streaming and changes to the ED medical workforce model, as well as linking hospitals with PHC clinics. Suggested system changes included improving rapid access to non-GP specialists, offering qualifications for urgent care within PHC, developing integrated information technology systems and educating patients regarding appropriate healthcare system pathways. CONCLUSION: The present study suggested that while PHC has the potential to attenuate the demands for ED services, a whole-of-system approach focusing on realignment of priorities and integrated changes are needed.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Emerg Med Australas
dc.relation.isbasedon	10.1111/1742-6723.13964
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services
dc.subject.classification	Emergency & Critical Care Medicine
dc.subject.classification	3202 Clinical sciences
dc.subject.mesh	Ambulatory Care Facilities
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	General Practice
dc.subject.mesh	General Practitioners
dc.subject.mesh	Humans
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Humans
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Ambulatory Care Facilities
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	General Practitioners
dc.subject.mesh	General Practice
dc.subject.mesh	Ambulatory Care Facilities
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	General Practice
dc.subject.mesh	General Practitioners
dc.subject.mesh	Humans
dc.subject.mesh	Qualitative Research
dc.title	Potential role of general practice in reducing emergency department demand: A qualitative study.
dc.type	Journal Article
utslib.citation.volume	34
utslib.location.activity	Australia
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2023-07-17T05:03:00Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	34
utslib.citation.issue	5

Abstract:

OBJECTIVE: To inform local, state and national strategies intended to reduce demand for ED care, the present study aimed to identify key factors influencing the current provision of acute care within primary healthcare (PHC) and explore the policy and system changes potentially required. METHODS: Semi-structured interviews with key stakeholders were audio-recorded, transcribed verbatim and analysed through content and thematic approaches incorporating the Walt and Gilson health policy framework. RESULTS: Eleven interviews were conducted. Five key considerations were highlighted, namely the barriers and enablers for general practitioners (GPs) in providing acute care, barriers to patient use of PHC instead of ED, suggestions for new PHC models and improvements for current ED models. Additionally, economic issues relating to clinic funding and GP remuneration, complexities of state or federal funding and management of urgent care centres (UCC) were identified. Potential policy changes included GP clinics incorporating emergency appointments, GP triage, further patient streaming and changes to the ED medical workforce model, as well as linking hospitals with PHC clinics. Suggested system changes included improving rapid access to non-GP specialists, offering qualifications for urgent care within PHC, developing integrated information technology systems and educating patients regarding appropriate healthcare system pathways. CONCLUSION: The present study suggested that while PHC has the potential to attenuate the demands for ED services, a whole-of-system approach focusing on realignment of priorities and integrated changes are needed.

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http://hdl.handle.net/10453/171555