Patient-reported impact of after-hours house-call services on the utilization of emergency department services in Australia

Chris O Ifediora, Gary D Rogers
2017 Family Practice  
Objectives: This paper explores, from the patients' perspective, the likely impact of the Australian after-hours house-call (AHHC) medical services on emergency department (ED) presentations. This has become imperative given the significant cost difference between patient presentations to either the AHHC or ED, and their practical implications for healthcare funding. Design, setting and participants: A cross-sectional, self-reported survey of all 10,838 patients in Australia known to have
more » ... known to have patronised AHHC services over the last week of January 2016. Main Outcome Measure: The study used a validated, self-completion questionnaire, dispatched through a mix of online and postal methods. Results: A total of 1,228 questionnaires were returned, of which 1,211 included all relevant sections of the survey (11.2% response rate). 486 patients (40.1%) indicated that they would have gone to the ED on the same day or night of their illness had the AHHC not been available, with the elderly (65 and above) and children (under 16) accounting for nearly two-thirds of these (64.6%). Following their AHHC consultations, 103 (8.5%) patients eventually attended the ED, meaning that the service prevented 383 patients from attending the ED, a decrease of 78.8%. Stratification based on location showed that this impact was seen across all states and territories in Australia where AHHC services exist, ranging from a reduction of 73.9% in Western Australia to 85.0% in Tasmania. Similarly, the impact cuts across all patient demographics, including age ranges, gender, and social divides. Conclusions: Based on our respondents' reports, AHHC services appear to be associated with a reduction in ED visits in Australia, with the impact cutting across all regions and patient demographics.
doi:10.1093/fampra/cmx038 pmid:28472461 fatcat:f2ccnfhoo5aljg533oa3uoxiam