Understanding the role of primary care access and appropriateness in hospital use: A Cross-sectional survey of patients attending a public hospital in the south east of Melbourne

Research output: Contribution to conferenceAbstractpeer-review


Context: Access to appropriate primary care has been seen as an important influence on the avoidable use of emergency departments. Objective: To explore the relationship between patient-perceived access to primary care and appropriateness of primary care in Emergency Department (ED) visits and hospital admissions in vulnerable populations. Design: Cross-sectional survey of patients attending a community dental service and ED. The survey, developed as part of the IMPACT Centre of Research Excellence, included measures of: social vulnerability; health utilization; ability to reach, engage in and pay for primary care; and primary care appropriateness (measured as patient-perceived patient-centeredness). Consenting participants’ surveys were linked to administrative data on ED and hospital admissions. Setting: Suburban emergency department and three sites of a community dental clinic, each within a large metropolitan health service. Participants: 459 patients, 245 from the dental service and 214 from the ED. Data linkage was achieved for 53.2% of participants. Findings: 7.0% lacked affiliation to a GP or practice. Patient-centeredness was high and was independent of primary care affiliation. Ability to access care was adequate, however 28.7% of participants reported not seeing a specialist in past 6 months due to cost. 5.9% reported difficulties getting healthcare as their reason for attending ED. Ability to access care and appropriateness appeared to not be associated with ED visits or hospital admissions. Implication(s) for practice: Primary care affiliation, access and patient-centeredness did not seem to influence ED attendance in this population. Interventions to reduce avoidable hospitalisation need to consider other contextual factors.
Original languageEnglish
Publication statusPublished - 5 Jul 2019
EventAustralasian Academic Association for Primary Care’s (AAAPC) Annual Research Conference 2019 - University of Adelaide, Adelaide, Australia
Duration: 12 Jul 201913 Jul 2019


ConferenceAustralasian Academic Association for Primary Care’s (AAAPC) Annual Research Conference 2019
Abbreviated titleAAAPC 2019 Annual Research Conference
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