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Access to primary care and visits to emergency departments in England: a cross-sectional, population-based study

Title: Access to primary care and visits to emergency departments in England: a cross-sectional, population-based study
Authors: Cowling, T
Soljak, M
Cecil, E
Lee, J
Millet, C
Majeed, A
Harris, M
Item Type: Journal Article
Abstract: Background The number of visits to hospital emergency departments (EDs) in England has increased by 20% since 2007-08, placing unsustainable pressure on the National Health Service (NHS). Some patients attend EDs because they are unable to access primary care services. This study examined the association between access to primary care and ED visits in England. Methods A cross-sectional, population-based analysis of patients registered with 7,856 general practices in England was conducted, for the time period April 2010 to March 2011. The outcome measure was the number of self-referred discharged ED visits by the registered population of a general practice. The predictor variables were measures of patient-reported access to general practice services; these were entered into a negative binomial regression model with variables to control for the characteristics of patient populations, supply of general practitioners and travel times to health services. Main Result and Conclusion General practices providing more timely access to primary care had fewer self-referred discharged ED visits per registered patient (for the most accessible quintile of practices, RR = 0.898; P<0.001). Policy makers should consider improving timely access to primary care when developing plans to reduce ED utilisation.
Issue Date: 12-Jun-2013
Date of Acceptance: 9-May-2013
URI: http://hdl.handle.net/10044/1/55748
DOI: https://dx.doi.org/10.1371/journal.pone.0066699
ISSN: 1932-6203
Publisher: Public Library of Science (PLoS)
Journal / Book Title: PLoS One
Volume: 8
Issue: 6
Copyright Statement: © 2013 Cowling et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
GENERAL-PRACTICE
ATTENDANCE RATES
PATIENT SURVEY
CASE-MIX
ACCIDENT
SERVICES
ASSOCIATION
DEPRIVATION
AUSTERITY
HEALTH
Cross-Sectional Studies
Emergency Service, Hospital
England
Health Services Accessibility
Humans
Primary Health Care
Regression Analysis
Time Factors
MD Multidisciplinary
General Science & Technology
Publication Status: Published
Article Number: e66699
Appears in Collections:School of Public Health