Allen Penny, Cheek Colleen, Foster Simon, Ruigrok Marielle, Wilson Deborah, Shires Lizzi
Rural Clinical School, University of Tasmania, Burnie, Tasmania, Australia.
Emerg Med Australas. 2015 Apr;27(2):113-8. doi: 10.1111/1742-6723.12366. Epub 2015 Feb 26.
To estimate the number of general practice (GP)-type patients attending a rural ED and provide a comparative rural estimate to a metropolitan study.
Analysis of presentations to the two EDs in Northwest Tasmania from 1 January 2009 to 31 December 2013 using the Diagnosis, Sprivulis, Australian College of Emergency Medicine (ACEM) and the Australian Institute of Health and Welfare (AIHW) methods to estimate the number of GP-type presentations.
There were 255,365 ED presentations in Northwest Tasmania during the study period. There were 86,973 GP-type presentations using the ACEM method, 142,006 using the AIHW method, 174,748 using the Diagnosis method and 28,922 low acuity patients identified using the Sprivulis method.
The proportion of GP-type presentations identified using the four methods ranged from 15% to 69%. The results suggest that triage status and self-referral are not reliable indicators of low acuity in this rural area. In rural areas with a shortage of GPs, it is likely that many people appropriately self-refer to ED because they cannot access a GP. The results indicate that the ACEM method might be most useful for identifying GP-type patients in rural ED. However, this requires validation in other regions of Australia.
估算前往农村急诊科就诊的全科医生（GP）类型患者数量，并与一项都市研究进行农村地区的比较估算。
对2009年1月1日至2013年12月31日期间塔斯马尼亚西北部两家急诊科的就诊情况进行分析，采用诊断法、斯普里武利斯法、澳大利亚急诊医学学院（ACEM）法和澳大利亚卫生与福利研究所（AIHW）法来估算全科医生类型就诊的数量。
在研究期间，塔斯马尼亚西北部有255,365人次到急诊科就诊。采用ACEM法有86,973人次属于全科医生类型就诊，采用AIHW法有142,006人次，采用诊断法有174,748人次，采用斯普里武利斯法识别出28,922名低 acuity患者。
使用这四种方法识别出的全科医生类型就诊比例在15%至69%之间。结果表明，在这个农村地区，分诊状态和自我转诊并非低 acuity的可靠指标。在全科医生短缺的农村地区，很可能许多人因为无法看全科医生而适当地自行前往急诊科就诊。结果表明，ACEM法可能最有助于识别农村急诊科的全科医生类型患者。然而，这需要在澳大利亚其他地区进行验证。
