Kaikhosrovi Mahsa, Bein Kendall, Haywood Philip, Seimon Radhika, Dinh Michael
RPA Green Light Institute, Sydney Local Health District, Sydney, New South Wales, Australia.
Emergency Department, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
Emerg Med Australas. 2025 Feb;37(1):e14538. doi: 10.1111/1742-6723.14538. Epub 2024 Nov 25.
Identify clinical and demographic characteristics of low-acuity presentations (LAPs) to the ED and analyse correlations between population rates of LAPs to ED and rates of Medicare-subsidised general practitioner (GP) services across statistical areas.
Retrospective data linkage study using state-wide ED data and publicly available data on GP services per population by statistical area. We performed multilevel logistic regression to determine predictors of LAP at an individual level after adjusting for remoteness categories and performed correlations between rates of LAP and GP services per population across statistical areas in New South Wales, Australia. The primary outcome was the rate of LAPs to ED, LAPs being defined as patients who self-presented to ED, assigned an Australasian Triage Score of 4 or 5 and subsequently discharged from ED.
There were 2.9 million ED presentations in 2021, of which 39.9% presentations were classified as LAP. LAPs were associated with younger age, routine care, eyes, ear, nose and throat and musculoskeletal presentations. The rate of LAPs was higher in non-metropolitan areas. Additionally, 85% of LAPs were seen and discharged from ED within 4 h. There was an inverse correlation between the rate of Medicare-subsidised GP services and the rate of total ED or LAPs in non-metropolitan areas (ρ = -0.47, ρ = -056 and P = 0.012, P = 0.001, respectively). In metropolitan areas, correlations were either positive for all ED presentations (ρ = +0.41, P = 0.007) or not significant for LAPs (ρ = +0.18, P = 0.57).
A relationship between LAPs to ED and Medicare-subsidised GP episodes of care exists for non-metropolitan but not metropolitan areas.
确定急诊科低急症就诊（LAPs）的临床和人口统计学特征，并分析各统计区域LAPs到急诊科的人口比率与医疗保险补贴的全科医生（GP）服务比率之间的相关性。
采用全州急诊科数据和按统计区域划分的公开可用的人均GP服务数据进行回顾性数据关联研究。在调整偏远类别后，我们进行多水平逻辑回归以确定个体层面LAP的预测因素，并对澳大利亚新南威尔士州各统计区域的LAP比率与人均GP服务进行相关性分析。主要结局是LAPs到急诊科的比率，LAPs定义为自行前往急诊科、澳大利亚分诊评分被评定为4或5且随后从急诊科出院的患者。
2021年有290万例急诊科就诊病例，其中39.9%的就诊病例被归类为LAPs。LAPs与年龄较小、常规护理、眼、耳、鼻、喉及肌肉骨骼系统就诊有关。非都市地区的LAPs比率较高。此外，85%的LAPs患者在4小时内就诊并从急诊科出院。在非都市地区，医疗保险补贴的GP服务比率与急诊科总就诊率或LAPs比率之间存在负相关（分别为ρ = -0.47，ρ = -0.56，P = 0.012，P = 0.001）。在都市地区，对于所有急诊科就诊病例，相关性为正（ρ = +0.41，P = 0.007），而对于LAPs则不显著（ρ = +0.18，P = 0.57）。
非都市地区存在LAPs到急诊科与医疗保险补贴的GP护理事件之间的关系，而都市地区不存在这种关系。
