ArticleBMJ open2013
Suitability of emergency department attenders to be assessed in primary care: survey of general practitioner agreement in a random sample of triage records analysed in a service evaluation project.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Primary care professionals providing non-urgent care in hospital emergency departments.The Cochrane database of systematic reviews · 2018Pooled it
- Differences in emergency nurse triage between a simulated setting and the real world, post hoc analysis of a cluster randomised trial.BMJ open · 2022Trial
- Insights from end-of-career general practitioners on changing working conditions and generational differences: considerations for future strategies.BMC primary care · 2024Article
- Inappropriate Use of Emergency Services from the Perspective of Primary Care Underutilization in a Local Romanian Context: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2024Article
- Non-urgent emergency department attendances in children: a retrospective observational analysis.Emergency medicine journal : EMJ · 2022Observational
- Learning from diagnostic errors to improve patient safety when GPs work in or alongside emergency departments: incorporating realist methodology into patient safety incident report analysis.BMC emergency medicine · 2021Article
- Factors influencing streaming to General Practitioners in emergency departments: A qualitative study.International journal of nursing studies · 2021Article
- Article
- Diagnostic strategies in general practice and the emergency department: a comparative qualitative analysis.BMJ open · 2019Article
- The impact of general practitioners working in or alongside emergency departments: a rapid realist review.BMJ open · 2019Review
- To GP or not to GP: a natural experiment in children triaged to see a GP in a tertiary paediatric emergency department (ED).BMJ quality & safety · 2018Article
- Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data.PloS one · 2018Article
- Continuity of Primary Care and Emergency Hospital Admissions Among Older Patients in England.Annals of family medicine · 2017Article
- An after hours gp clinic in regional Australia: appropriateness of presentations and impact on local emergency department presentations.BMC family practice · 2017Article
- Exploring the relationship between general practice characteristics and attendance at Walk-in Centres, Minor Injuries Units and Emergency Departments in England 2009/10-2012/2013: a longitudinal study.BMC health services research · 2017Article
- Parental and Pediatricians' Perception of Need for Subspecialty Training in Pediatric Emergency Medicine for Delivering Emergency Care to Pediatric Patients.Global pediatric health · 2017Article
- Use of the SONET score to evaluate Urgent Care Center overcrowding: a prospective pilot study.BMJ open · 2015Article
- Article
- Emergency hospital admissions via accident and emergency departments in England: time trend, conceptual framework and policy implications.Journal of the Royal Society of Medicine · 2014Review
- Access to general practice and visits to accident and emergency departments in England: cross-sectional analysis of a national patient survey.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the proportion of emergency department (ED) attendances that would be suitable for primary care and the inter-rater reliability of general practitioner (GP) assessment of primary care suitability. DESIGN OF STUDY: Survey of GPs' agreement of suitability for primary care on a random anonymised sample of all ED patients attending over a 1-month period.
settingED of a UK Hospital serving a population of 600 000.
methodFour GPs independently used data extracted from clinical notes to rate the appropriateness for management in primary care as well as need for investigations, specialist review or admission. Agreement was assessed using Cohen's κ.
resultsThe mean percentage of patients that GPs considered suitable for primary care management was 43% (range 38-47%). The κ for agreement was 0.54 (95% CI 0.44 to 0.64) and 0.47(95% CI 0.38 to 0.59). In patients deemed not suitable for primary care, GPs were more likely to determine the need for specialist review (relative risks (RR)=3.5, 95% CI 3.0 to 4.2, p<0.001) and admission (RR=3.9, 95% CI 3.2 to 4.7, p<0.001). In patients assessed as suitable for primary care, GPs would initiate investigations in 51% of cases. Consensus over primary care appropriateness was higher for paediatric than for adult attenders.
conclusionsA significant number of patients attending ED could be managed by GPs, including those requiring investigations at triage. A stronger agreement among GPs over place of care may be seen for paediatric than for adult attenders. More effective signposting of patients presenting with acute or urgent problems and supporting a greater role for primary care in relieving the severe workflow pressures in ED in the UK are potential solutions.
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