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Quantifying the proportion of general practice and low-acuity patients in the emergency department

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Between June 2005 and October 2009, attendances to emergency departments (EDs) across Australia increased by 21.2%. This represents an annual increase of 4.9%, which significantly exceeds the rate of population growth.1 Reasons postulated include an ageing population, the rising incidence of chronic illness and decreased availability of general practitioners, especially for after-hours and urgent visits. The latter issue has led to suggestions that overcrowding in EDs is due to patients with general practice-type conditions attending inappropriately and is driven to some extent by poorly validated definitions of “inappropriate” attendances.2

In Australia, methods to determine the number of general practice-type patients attending EDs often use the Australasian Triage Scale (ATS). The ATS is a method used to prioritise care within EDs, with all patients allocated a category from 1 to 5 on arrival. Category 1 patients are regarded as the highest priority, while category 5 patients are the least urgent.3 It has been postulated that general practice-type patients are associated with ATS categories 4 and 5, but this is not well founded.1,