Emergency department crowding: How valuable is GPs information?

Abstract

Can GPs referral reduce the inappropriate use of Emergency Departments (ED)? Our paper allows us to shed some light on this policy relevant issue by exploiting a unique dataset of 38,572 admission records from the province of Trento in 2018. The dataset contains, among other things, specific information on how the decision to visit the ED (i.e., was it the patient's own decision or was the visit based on the advice of their GP) was made. In our data, 10.5 % of the accesses are inappropriate but we find that GP referrals reduce the probability of inappropriate access by 6.5 percentage points on average; the results are robust to changes in parameters and estimation models. From a policy perspective, the analysis suggests that GPs could play a crucial role in reducing overcrowding in EDs and provides quantitative support for the use of fast-tracking GP referrals as a possible management strategy.

Keywords: Emergency departments; Fast track; GP referrals; Inappropriate use; Overcrowding.