Putting to rest the myth that emergency department overcrowding is due to a lack of primary care services
Australia’s emergency departments (EDs) are dangerously overcrowded, but a study by Buckley and colleagues in this issue of the Journal1 should be the last nail in the coffin of the long-discredited myth that the root cause is a lack of primary care services. This study used a time series approach to identify a real — but clinically insignificant — change in ED workload after the opening of an after-hours primary care service in the New South Wales inland rural city of Wagga Wagga. The Australian public are entitled to receive high-quality and available care in both primary care and emergency settings, but the overlap between these services is not as important as many have claimed.2,3
The full article is accessible to AMA
members and paid subscribers.
Login to MJA or subscribe now.
- 1. Buckley DJ, Curtis PW, McGirr JG. The effect of a general practice after-hours clinic on emergency department presentations: a regression time series analysis. Med J Aust 2010; 192: 448-451. <MJA full text>
- 2. AM (ABC Radio). Carr proposes setting up more GP clinics near emergency departments [transcript]. 2003; 18 Aug. http://www.abc.net.au/am/content/2003/s926366.htm (accessed Mar 2010).
- 3. NSW Health. After-hours GP service supports Sutherland Hospital’s Emergency Department [media release]. 2009; 4 May. Sydney: NSW Government, 2009. http://www.sesiahs.health.nsw.gov.au/News_and_Events/2009/20090504_AfterHoursGPService.asp (accessed Mar 2010).
- 4. Sprivulis P. Estimation of the general practice workload of a metropolitan teaching hospital emergency department. Emerg Med (Fremantle) 2003; 15: 32-37.
- 5. Sprivulis P, Grainger S, Nagree Y. Ambulance diversion is not associated with low acuity patients attending Perth metropolitan emergency departments. Emerg Med Australas 2005; 17: 11-15.
- 6. Duckett SJ, Jackson T. Paying for hospital emergency care under a single-payer system. Ann Emerg Med 2001; 37: 309-317.
- 7. Richardson D, Kelly AM, Kerr D. Prevalence of access block in Australia 2004–2008. Emerg Med Australas 2009; 21: 472-478.
- 8. Schull MJ, Kiss A, Szalai JP. The effect of low-complexity patients on emergency department waiting times. Ann Emerg Med 2007; 49: 257-264.
My unit has received research funding from the Australasian College for Emergency Medicine.