Primary care patients in the emergency department: who are they? A review of the definition of the 'primary care patient' in the emergency department

Emerg Med Australas. Oct-Dec 2005;17(5-6):472-9. doi: 10.1111/j.1742-6723.2005.00779.x.

Abstract

Objective: To review the definition of 'primary care' and 'inappropriate' patients in ED and develop a generally acceptable working definition of a 'primary care' presentation in ED.

Method: A Medline review of articles on primary care in ED and the definitions used.

Results: A total of 34 reviewed papers contained a proposed definition or comment on the definition for potential 'primary care', 'general practice', or 'inappropriate' patients in ED. A representative definition was developed premised on the common factors in these papers: low urgency/acuity--triage categories four or five in the Australasian Triage Scale, self-referred--by definition, patients referred by general practitioner/community primary medical services are not primary care cases because a primary care service has referred them on, presenting for a new episode of care (i.e. not a planned return because planned returns are not self-referred), unlikely to be admitted (in the opinion of Emergency Nurse interviewers) or ultimately not admitted.

Discussion: This definition can be applied either prospectively or retrospectively, depending on the purpose. Appropriateness must be considered in light of a legitimate role for ED in primary care and the balance of resources between primary care and emergency medicine in local settings.

Publication types

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

MeSH terms

  • Acute Disease
  • Australia
  • Canada
  • Emergency Service, Hospital / organization & administration*
  • Europe
  • Family Practice
  • Humans
  • Patient Acceptance of Health Care
  • Patient Admission
  • Primary Health Care / organization & administration*
  • Research Design
  • Terminology as Topic*
  • Triage / methods
  • United States