Access to Primary Care and Visits to Emergency Departments in England: A Cross-Sectional, Population-Based Study
AuthorCowling, TE; Cecil, EV; Soljak, MA; Lee, JT; Millett, C; Majeed, A; Wachter, RM; Harris, MJ
Source TitlePLoS One
PublisherPUBLIC LIBRARY SCIENCE
University of Melbourne Author/sLee, Ta-Yu
AffiliationMelbourne School of Population and Global Health
Document TypeJournal Article
CitationsCowling, T. E., Cecil, E. V., Soljak, M. A., Lee, J. T., Millett, C., Majeed, A., Wachter, R. M. & Harris, M. J. (2013). Access to Primary Care and Visits to Emergency Departments in England: A Cross-Sectional, Population-Based Study. PLOS ONE, 8 (6), https://doi.org/10.1371/journal.pone.0066699.
Access StatusOpen Access
BACKGROUND: The number of visits to hospital emergency departments (EDs) in England has increased by 20% since 2007-08, placing unsustainable pressure on the National Health Service (NHS). Some patients attend EDs because they are unable to access primary care services. This study examined the association between access to primary care and ED visits in England. METHODS: A cross-sectional, population-based analysis of patients registered with 7,856 general practices in England was conducted, for the time period April 2010 to March 2011. The outcome measure was the number of self-referred discharged ED visits by the registered population of a general practice. The predictor variables were measures of patient-reported access to general practice services; these were entered into a negative binomial regression model with variables to control for the characteristics of patient populations, supply of general practitioners and travel times to health services. MAIN RESULT AND CONCLUSION: General practices providing more timely access to primary care had fewer self-referred discharged ED visits per registered patient (for the most accessible quintile of practices, RR = 0.898; P<0.001). Policy makers should consider improving timely access to primary care when developing plans to reduce ED utilisation.
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