After-hours primary care presentations in the St George Hospital and the Sutherland Hospital Emergency Departments
Central Eastern Sydney Primary Health Network
Duration: January – June 2017
Emergency department presentations in Australia are increasing annually. Potential primary care presentations are non-urgent presentations which can be dealt with by a general practitioner or other primary care provider rather than requiring the specialist services of an emergency department. Emergency departments are the most expensive of all after-hours primary care pathways and getting ‘the right care in the right place at the right time’ is a national health priority. A grant was received from the Central Eastern Sydney Primary Health Network to determine the level of primary care presentations in the after-hours period in the St George Hospital and the Sutherland Hospital Emergency Departments.
What we did
The study was a quantitative cross-sectional study, involving a retrospective audit of medical records. The existing code frame to determine a primary care appropriate presentation developed by Bezzina et al. (2005) and Siminski et al. (2008) was expanded on and tested on nearly 20,000 emergency department presentations. The final code frame was then applied to five years of emergency department data (over 601,000 presentations) at the St George Hospital and The Sutherland Hospital. Using this definition we found that 28% of all presentations in these hospitals were found to be potential primary care appropriate presentations, and that 19% of all presentations occurred in the after-hours period.
We then compiled a population profile of these patients and determined that the demographic profiles of potential primary care patients in the after-hours periods were different to the population demographics for the Local Government Areas within the hospital catchment areas. Our list of recommendations, along with this demographic information, will enable the Central Eastern Sydney Primary Health Network to develop and implement specifically targeted interventions to these population groups.
Project team: Heike Schütze and Kathy Eagar