Academic Journal
Management of non-urgent paediatric emergency department attendances by GPs: a retrospective observational study
| العنوان: | Management of non-urgent paediatric emergency department attendances by GPs: a retrospective observational study |
|---|---|
| المؤلفون: | Leigh, Simon, Mehta, Bimal, Dummer, Lillian, Aird, Harriet, McSorley, Sinead, Oseyenum, Venessa, Cumbers, Anna, Ryan, Mary, Edwardson, Karl, Johnston, Phil, Robinson, Jude, Coenen, Frans, Taylor Robinson, David, Niessen, Louis, Carroll, Enitan |
| المصدر: | British Journal of General Practice, Vol 71, Issue 702, e22-e30. |
| بيانات النشر: | Royal College of General Practioners |
| سنة النشر: | 2021 |
| المجموعة: | LSTM Online Archive (Liverpool School of Tropical Medicine) |
| مصطلحات موضوعية: | WS 100 General works, WX 215 Emergency service. Ambulance service |
| الوصف: | BACKGROUND Non-urgent emergency department (ED) attendances are common among children. Primary care management may not only be more clinically appropriate, but also improve patient experience and cost-effectiveness. AIM To determine the impact of integrating a general practitioner (GP) into a paediatric ED, on admissions, waiting times, antibiotic prescribing, and treatment costs. DESIGN & SETTING Retrospective cohort study of non-urgent ED-presentations in an English paediatric ED. METHOD From October-2015-September-2017, a GP was situated within the ED, from 2pm-10pm, seven-days-a-week. All children triaged green using the Manchester Triage System (non-urgent) were considered ‘GP-appropriate’. In cases of GP non-availability, non-urgent children were managed by ED staff. We compared clinical and operational outcomes, and healthcare costs, of children managed by GPs and ED-staff over the same timeframe (2pm-10pm), over a two-year period. RESULTS Of 115,000 children attending the ED over the study period, 13,099 children were designated ‘GP appropriate’, 8,404 (64.2%) managed by GPs and 4,695(35.8%) by ED staff. Median duration of ED-stay was 39min (IQR 16-108) in the GP-group and 165min (IQR 104-222) in the EDgroup(p<0.001). The GP-group were less likely to: be admitted as inpatients (OR 0.16, 95%CI 0.13-0.2) and wait longer than four-hours (OR 0.1, 95%CI 0.08-0.13), but more likely to receive antibiotics (OR 1.42, 95%CI 1.27-1.58). Treatment costs were 18.4% lower in the GP-group, p<0.0001. CONCLUSION Based on retrospective observational data, children seen by the GP in the emergency department waited less time, had fewer inpatient admissions and lower costs, but experienced higher antibiotic prescribing. Given rising demand for children’s emergency services, ‘GP in ED’ care models may improve the management of non-urgent ED presentations, however further research incorporating causative study designs is required. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| Relation: | https://archive.lstmed.ac.uk/16238/1/BJGP%20paper%20Niessen%20et%20al.%20as%20senior%20author.pdf; Leigh, Simon, Mehta, Bimal, Dummer, Lillian, Aird, Harriet, McSorley, Sinead, Oseyenum, Venessa, Cumbers, Anna, Ryan, Mary, Edwardson, Karl, Johnston, Phil, Robinson, Jude, Coenen, Frans, Taylor Robinson, David, Niessen, Louis orcid:0000-0002-8639-5191 and Carroll, Enitan (2021) 'Management of non-urgent paediatric emergency department attendances by GPs: a retrospective observational study'. British Journal of General Practice, Vol 71, Issue 702, e22-e30. |
| الاتاحة: | https://archive.lstmed.ac.uk/16238/ https://bjgp.org/content/early/2020/11/20/bjgp20X713885 https://archive.lstmed.ac.uk/16238/1/BJGP%20paper%20Niessen%20et%20al.%20as%20senior%20author.pdf |
| Rights: | cc_by_4 |
| رقم الانضمام: | edsbas.29AE1816 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |