Transfers from residential aged care facilities to the emergency department are reduced through improved primary care services: An intervention study

Authors

  • Jim Codde,

    1. South Metropolitan Area Health Service, Perth, Western Australia, Australia
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  • Glenn Arendts,

    Corresponding author
    1. Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research and University of Western Australia; Discipline of Emergency Medicine, Royal Perth Hospital; and School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Western Australia, Australia
      Dr Glenn Arendts, Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research and University of Western Australia. Email: glenn.arendts@uwa.edu.au
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  • Jackie Frankel,

    1. Fremantle GP Network, Fremantle, Western Australia, Australia
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  • Mary Ivey,

    1. Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia
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  • Tracy Reibel,

    1. School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Western Australia, Australia
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  • Shirley Bowen,

    1. Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia
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  • Paul Babich

    1. Fremantle GP Network, Fremantle, Western Australia, Australia
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Dr Glenn Arendts, Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research and University of Western Australia. Email: glenn.arendts@uwa.edu.au

Abstract

Aim:  To assess the impact of an enhanced primary care service for residential aged care facilities (RACF) on the transfer of patients from RACF to a hospital emergency department (ED).

Methods:  A before–after study of an enhanced primary care service provided by experienced ED-based nurses under the governance of general practitioners. The intervention was analysed comparatively using standardised normal deviates and seasonal autoregressive integrated moving average models, complemented by qualitative assessment.

Results:  There was a statistically significant reduction (17%, P < 0.001) in the number of transfers during the intervention period. This finding held when adjusting for the seasonality of ED referrals over a 4-year period. The intervention was highly valued by clinicians in RACF and ED.

Conclusion:  Enhanced primary care services reduce the number of transfers to ED from RACF.

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