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Extending primary care hours is linked to fewer emergency department visits

Keeping primary care practices open for extra hours on nights and weekends was linked to a discount in patient-initiated emergency department visits for minor issues, in accordance to a brand new research revealed in PLOS Medicine by William Whittaker of University of Manchester, UK, and colleagues.

Most basic practitioners within the UK present primary care providers from eight:30am to 6:30pm, and sufferers who want care outdoors of those hours typically flip to emergency departments; an estimated 26.5% of ED visits in England comply with unsuccessful makes an attempt to entry primary care. In an try to decrease the prices related to ED visits, NHS England (Greater Manchester) offered £three.1 million to allow 56 primary care practices within the Greater Manchester space to present further night and weekend pressing and routine appointments throughout 2014. Using routinely collected knowledge from 2011 to 2014, Whittaker and colleagues in contrast the change within the variety of ED visits by the 346,024 sufferers of the extended-access practices to the two,596,330 sufferers from 469 practices offering routine entry.

The researchers discovered that sufferers registered to the extended-access practices had a 26.four % relative discount in patient-initiated emergency department visits for minor issues in contrast with sufferers from practices offering routine entry, with 10,933 fewer such visits per yr. For each three booked further primary care appointment slots added to a apply’s schedule, 1 ED go to was prevented. Moreover, there was a 26.6 % relative discount in prices of minor ED visits, saving £767,976. However, there was no statistically vital relative discount in general ED visits, and on the idea of emergency department financial savings alone, extending primary care is unlikely to be cost-effective, the researchers concluded. The research didn’t have sufficient knowledge to carry out a proper cost-effectiveness evaluation, nevertheless, and no knowledge have been collected on affected person health outcomes. As a end result, the evaluation doesn’t take into accounts the potential advantages to these sufferers utilizing further appointments who wouldn’t have visited emergency departments in any other case.

“Our study suggests that extending opening hours in primary care may be a useful addition to policies aiming to reduce pressures on hospital services, potentially reducing patient-initiated use of the emergency department for minor problems – but at a significant cost,” the authors say.

Article: Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis, Whittaker W, Anselmi L, Kristensen SR, Lau Y-S, Bailey S, Bower P, et al., PLoS Med, doi:10.1371/journal.pmed.1002113, revealed on-line 6 September 2016.

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