Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, NSW, Australia.
Marathon Health, Bathurst, NSW, Australia.
BMC Fam Pract. 2017 Sep 11;18(1):86. doi: 10.1186/s12875-017-0657-6.
After hours general practice clinics provide medical attention for clients with non-emergency situations but are seeking immediate treatment and unable to wait for a general practitioner during routine opening hours. Evidence on the impact that after hours clinics have on emergency department presentations is equivocal. This study explored outcomes of the Bathurst After Hours General Practice Clinic (BAHGPC). Specifically it examined: clients' perceived urgency of, and satisfaction with their presentation to the BAHGPC; general practitioners' perception of the appropriateness of presentations to the BAHGPC; and whether the frequency of non-urgent and semi-urgent emergency department presentations at Bathurst Base Hospital has changed since the opening of the BAHGPC.
Clients presenting to the BAHGPC from 01/02/2015 to 30/06/2015 were asked to participate in the client presentation survey and follow-up satisfaction survey. General practitioner surveys were completed for individual clients from 01/12/2014 to 30/06/2015 to document the appropriateness of each presentation. Descriptive statistics are used to describe survey responses. Thematic analysis was applied for qualitative responses. Emergency department presentations were retrieved from the Emergency Department Data Collection. A comparison of presentations in the two years prior and subsequent to the opening of the BAHGPC was conducted using independent T-tests and Chi-square tests to compare mean presentations and proportional data for the different time periods examined.
Most clients (76%) presenting to the BAHGPC classified their visit as essential. General practitioners considered most presentations to be appropriate (87%). Sixty percent (60%) of clients would have gone to the emergency department had the BAHGPC not been operational. Client satisfaction was high and 99% would use the clinic again. A significant reduction in total non-urgent presentations to the Emergency Department occurred in the two years since the opening of the BAHGPC clinic compared to the two years prior (418.5 vs. 245.5; P < 0.05).
There was concordance between general practitioners and clients regarding the appropriateness of presentations to the BAHGPC. The findings of this study highlight that after hours general practitioner clinics are an essential service in regional areas and contribute to reducing the burden of non-urgent presentations to the local emergency department.
非营业时间的全科医生诊所为有非紧急情况的客户提供医疗服务，但他们希望立即得到治疗，并且无法在常规营业时间等待全科医生。关于下班后诊所对急诊就诊的影响的证据尚无定论。本研究探讨了巴瑟斯特下班后全科医生诊所（BAHGPC）的结果。具体而言，它检查了：客户对向 BAHGPC 就诊的紧迫性和满意度；全科医生对向 BAHGPC 就诊的适当性的看法；以及自 BAHGPC 开业以来，巴瑟斯特基地医院非紧急和半紧急急诊科就诊的频率是否发生了变化。
2015 年 2 月 1 日至 6 月 30 日期间向 BAHGPC 就诊的客户被邀请参加客户就诊调查和后续满意度调查。2014 年 12 月 1 日至 6 月 30 日期间，针对每位客户完成了全科医生调查，以记录每次就诊的适当性。使用描述性统计数据描述调查结果。对定性回复进行了主题分析。从急诊科数据采集系统中检索到急诊科就诊情况。通过独立 T 检验和卡方检验比较不同时间段的就诊平均值和比例数据，比较了开业前后两年的就诊情况。
向 BAHGPC 就诊的大多数客户（76%）将他们的就诊归类为必要就诊。全科医生认为大多数就诊是适当的（87%）。如果 BAHGPC 不运营，60%（60%）的客户将前往急诊室。客户满意度很高，99%的客户会再次使用该诊所。与开业前两年相比，BAHGPC 诊所开业后的两年中，急诊科非紧急就诊总数显著减少（418.5 比 245.5；P < 0.05）。
全科医生和客户对向 BAHGPC 就诊的适当性的看法一致。本研究的结果表明，下班后全科医生诊所是地区性服务的重要组成部分，并有助于减少当地急诊科非紧急就诊的负担。
