One of the most effective ways I have seen of keeping patients with lower
acuity problems out of emergency departments was in Australia. GPs are paid
on a fee per item basis so it is in their interest to ensure they can see as
many patients as possible and as often as possible. This makes for expensive
primary care but the health care system reckons its still cheaper than
having these patients access emergency departments where a similar cohort of
patients that are dealt with effectively by general practitioners will end
up using up more hospital resources and expense.
One downside I noticed however was that some general practitioners held onto
their patients for to long so that they were much sicker than one would have
liked when they finally arrived in the ED.
Dr John M Ryan
Consultant & Senior Lecturer in A&E medicine
Royal Sussex County Hospital
Eastern Rd.
Brighton
UK
Ph; 00 44 1273 696955
Fax: 00 44 1273 680627
http://www.pavilion.co.uk/users/ryanj/
http://www.rsch.org.uk/rsch/rschae.htm
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