Primary care in accident and emergency and general practice: a comparison

Soc Sci Med. 1992 Oct;35(8):987-95. doi: 10.1016/0277-9536(92)90238-l.


This paper reviews the way in which literature describing 'inappropriate' attenders at Accident and Emergency (A & E) departments in Britain has suggested that they could be provided for in General Practice and that their attendance at A & E departments therefore implies a 'failure' of general practice in urban areas. One problem with much previous research is that 'inappropriate' attenders have been retrospectively identified. The comparative survey of attenders at a London A & E department and patients visiting their GP in the same district reported here prospectively identified A & E attenders with primary care problems and examined the differences between them and the GP attenders. Patients attending the hospital A & E department were similar to the GP attenders in terms of socio-economic indicators, but had problems which were not typical of the general practice workload and were in different circumstances. The results suggest that there will be a continuing demand for hospital-provided primary care in urban areas, and that attempts to deflect such care to the community will meet with limited success.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude to Health
  • Child
  • Child, Preschool
  • Choice Behavior
  • Emergency Service, Hospital / statistics & numerical data*
  • Family Practice / standards*
  • Female
  • Health Services Accessibility / standards
  • Health Services Misuse / statistics & numerical data*
  • Health Services Research
  • Hospitals, University
  • Humans
  • Infant
  • London
  • Male
  • Middle Aged
  • Occupations
  • Patient Satisfaction
  • Primary Health Care / statistics & numerical data*
  • Social Class
  • Surveys and Questionnaires
  • Triage
  • Waiting Lists