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Rural emergency departments supplement general practice care

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To the Editor: To provide a rural comparison to Nagree and colleagues’ metropolitan study,1 we estimated the number of general practice-type patients attending emergency departments (EDs) in north-west Tasmania.

Ethics approval was granted by the Tasmanian Health and Medical Human Research Ethics Committee.

We used two methods of identifying general practice-type visits to analyse 152 481 ED presentations to the North West Regional Hospital (Burnie) and the Mersey Community Hospital (Latrobe) from January 2011 to December 2013.

The Australasian College for Emergency Medicine (ACEM) method categorises as possibly suitable for a general practice consultation patients who are self-referred, do not arrive by ambulance and have a medical consultation time under 1 hour. Patients who did not wait to be seen by a doctor or had an invalid treatment time are excluded. Over the 3 years, we identified 51 770 general practice-type presentations using this method (34.9%). There were 60 684 presentations included in the ACEM method on weekdays, with 19 541 (32.2%) identified as general practice-type patients (Box). However, ACEM general practice-type patients occupied only 7%–8% of total ED treatment time.

The Australian Institute of Health and Welfare (AIHW) method categorises as general practice-type…