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Exploring the relationship between general practice characteristics, and attendance at walk-in centres, minor injury units and emergency departments in England 2012/2013: A cross-sectional study

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)702-708
Number of pages7
JournalEmergency Medicine Journal
Volume33
Issue number10
Early online date17 Jun 2016
DOIs
DateAccepted/In press - 14 May 2016
DateE-pub ahead of print - 17 Jun 2016
DatePublished (current) - Oct 2016

Abstract

Background
For several years, emergency departments (ED) in the UK National Health Service have faced considerable increases in attendance rates. Walk-in Centres (WiC), Minor Injuries Units (MIU) have been suggested as solutions. We aimed to investigate associations between practice and practice population characteristics with ED attendance rates or combined ED/WiC/MIU attendance, and associations between WiC/MIU, and ED attendance.
Methods
We used general practice-level data including 7,462 English practices in 2012/13, and present adjusted regression coefficients from linear multivariable analysis for relationships between patients’ emergency attendance rates and practice characteristics.
Results
Every percentage-point increase in patients reporting inability to make an appointment was associated with an increase in emergency attendance by 0.36 (95%CI 0.06, 0.66) per 1,000 population. Percentage-point increases in patients unable to speak to a GP/nurse within 2 workdays and patients able to speak often to their preferred GP were associated with increased emergency attendance/1,000 population by 0.23 (95%CI 0.05, 0.42) and 0.10 (95%CI 0.00, 0.19) respectively. Practices in areas encompassing several towns (conurbations) had higher attendance than rural practices, as did practices with more non-UK-qualified GPs. Practice population characteristics associated with increased emergency attendance included higher unemployment rates, higher percentage of UK-whites, and lower male life-expectancy, which showed stronger associations than practice characteristics. Furthermore, higher MIU or WiC attendance rates were associated with lower ED attendance rates.
Conclusions
Improving availability of appointments and opportunities to speak a GP/nurse at short notice might reduce ED attendance. Establishing MIUs and WiCs might also reduce ED attendance.

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  • Full-text PDF (accepted author manuscript)

    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via BMJ Publishing Group at http://dx.doi.org/10.1136/emermed-2015-205339. Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 1 MB, PDF-document

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