The appropriateness of A&E attendances: a prospective study

This prospective study was undertaken to establish the extent and source of appropriateness of attendances at the Accident & Emergency Department of University College Hospital Galway. All new attendees to the department within a two week period were surveyed and differences were observed between the sources of referral. Analysis of the results showed that general practitioner referrals were older, had a longer duration of complaint and required more investigations than self referred patients. Of requested admissions by general practitioners 82.7% were finally admitted. Self referred patients had a shorter duration of complaint, were more likely to present with fractures, dislocation or soft tissue injuries and less likely to require admission (9.8%). Within this region approximately 10% of attendances were inappropriate and were distributed equally between general practitioner and self referrals. This study found that reassessment by A&E staff of requested admissions is not beneficial. The level of abuse is low. There is no more abuse of A&E by patients who attend A&E without seeing their General Practitioner than by those who have.