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Aims This study aims to quantify the number of perceived primary care patients attending an emergency department, to determine whether it was safe to send them away and to estimate the costs of treatment. Setting The Emergency Department, Ballarat Base Hospital, a major provincial hospital. Methods A prospective analysis of all attendances over a 14 day period, including the costs of managing primary care patients. Results One thousand and forty nine patients attended the emergency department during the study period. Data were complete for 858 patients. There was agreement between medical and triage staff that 263 patients were primary care patients. Triage staff considered 295 patients to be primary care patients. Nine of these patients were subsequently admitted. The average cost for each patient visit to the emergency department was $120.38. The cost of staff contact time for a 15 minute visit was $23.59. If it is assumed that the number of primary care patients attending does not affect staffing levels then the cost is $16.99. Conclusion There is disagreement between triage and medical staff about who is a primary care patient. Three percent of patients thought to have been able to be managed by a general practitioner needed admission. There are large numbers of patients presenting to the emergency department thought to have been able to be managed by a general practitioner but their numbers are insufficient to support a separate primary care facility within Ballarat Base Hospital. Costs are less to manage primary care patients in the emergency department at Ballarat Base Hospital than in general practice. The cost associated with teaching medical and nursing students, including postgraduate education, in the emergency department has not been quantified. |
