General practitioner consultation after a visit to the emergency department: an observational study.

Abstract:

BACKGROUND:Some studies have demonstrated an association between poor continuity of care, high likelihood of 'inappropriate' use of emergency departments (EDs) and avoidable hospitalization. However, we lack data concerning primary care use after an ED visit. OBJECTIVE:Identify the determinants of a visit to the general practitioner (GP) after an ED visit.Methods. DESIGN:Observational study (single-centre cohort). SETTING:One emergency department in Paris, France. SUBJECTS:All adult patients who presented at the ED and were discharged. MAIN OUTCOME MEASURE:We collected data by the use of a standardized questionnaire, patients' medical records and a telephonic follow-up. Descriptive analyses were performed to compare individuals with and without a GP. Then, for those with a GP, multivariate logistic regression was used to identify the determinants of the GP consultation. RESULTS:We included 243 patients (mean age 45 years [±19]); 211 (87%) reported having a GP. Among those who reported having a GP, 52% had consulted their GP after the ED visit. Not having a GP was associated with young age, not having complementary health insurance coverage, and being single. GP consultation was associated with increasing age [adjusted odds ratios (aOR) = 1.03], poor self-reported health status (aOR = 2.25), medical complaints versus traumatic injuries (aOR = 2.24) and prescription for sick note (aOR = 5.74). CONCLUSION:Not having a GP was associated with factors of social vulnerability such as not having complementary health insurance coverage. For patients with a GP, consultation in the month after an ED visit seems appropriate, because it was associated with poor health status and medical complaints.

journal_name

Fam Pract

journal_title

Family practice

authors

Rotival J,Yordanov Y,Thiebaud PC,Pelletier-Fleury N,Jacquet E,Debuc E,Pateron D,Naouri D

doi

10.1093/fampra/cmy054

subject

Has Abstract

pub_date

2019-03-20 00:00:00

pages

132-139

issue

2

eissn

0263-2136

issn

1460-2229

pii

5042243

journal_volume

36

pub_type

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