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Seeing the same GP each time can reduce emergency department attendance, review finds

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4847 (Published 28 July 2014) Cite this as: BMJ 2014;349:g4847
  1. Zosia Kmietowicz
  1. 1The BMJ

Enabling patients to see the same GP every time they visit their doctor’s surgery is associated with reduced emergency department attendance and fewer hospital admissions, a review has concluded.1

Researchers from the University of Bristol conducted a systematic review to try to identify features that could help stem the rise in unscheduled care in the United Kingdom. They looked at 48 studies from around the world that examined potential factors influencing emergency department visits and emergency admissions. The review, published in BMJ Open, found that patients who saw the same GP every time they attended their GP surgery were less likely to require emergency care.

Other factors that also affected admissions and attendances at emergency departments were: how easy it was for patients to access GP surgeries and primary care providers; how far the patients lived from the emergency department; and the number of confusing options patients had to deal with when accessing emergency care.

Alyson Huntley, research fellow at the University of Bristol and lead author of the report, said, “A recent report by the King’s Fund suggested that admissions among people with long term conditions that could have been managed in primary care cost the NHS £1.42bn [€1.8bn; $2.4bn] per year. This could be reduced by up to 18% through investment in primary and community based services.

“Our work has shown that providing continuity of care and making it easier for patients to get access to their GP can help achieve this reduction in unplanned admissions and emergency department attendance.”

Sarah Purdy, who led the research, said, “GP practices serving the most deprived populations have emergency admission rates that are around 60% higher than those serving the least deprived populations. Our research has highlighted key issues that commissioners of primary care in the UK can tackle in order to bring down unscheduled secondary care use.”

The researchers recommended that, for patients in high risk groups, there should be a targeted increase in continuity of care with their GPs. These include older patients, those from poorer backgrounds, and those with multiple conditions.

The researchers acknowledged some limitations to their study, including the fact that several studies reported only univariable analysis, which can limit the identification of factors that influence the measures of unscheduled care. Other studies involved discrete populations and findings that might not be applicable to wider groups. Similarly, studies from outside the UK may not be applicable to the NHS.

Notes

Cite this as: BMJ 2014;349:g4847

References

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