Aim: To estimate the proportion of Middlemore Hospital Emergency Department (ED) attendances that GPs thought could be handled in primary care.
Methods: A retrospective review of 300 randomly selected discharge summaries of non-admitted patients by 12 GPs.
Results: Data were available from 278 discharges. Agreement between GP reviewers was "fair" (kappa = 0.34, Kendall's W = 0.48). In 50 cases, the GPs were unanimous that the case was a primary care case (18%). In two cases, there was unanimity that the case was an ED case (<1%). The 12 GPs assessed that an average of 56% (range 38-81%) of the cases they reviewed could have been handled in their surgeries yesterday with no extra resources. This suggests that 34% of the total ED caseload (ie, including admitted patients) could be managed in primary care.
Conclusions: A significant proportion of ED attendances at Middlemore Hospital could be handled in primary care; however, there is considerable variation in GP estimates of this proportion.