Primary Care Access, Emergency Department Visits, and Unplanned Short Hospitalizations in the UK

Area of Science:

• Pediatric Health Services Research
• Primary Care Access
• Healthcare Utilization

Background:

• Rising demand for unplanned hospital services, with children being frequent users.
• Variable access to general practitioner (GP) appointments in England impacts primary care.
• Limited out-of-hours (OOH) access to regular GPs for many patients.

Purpose of the Study:

• To explore the association between GP accessibility and emergency department (ED) visits in children.
• To investigate the relationship between GP accessibility and short hospitalizations (<2 days) in children.
• To analyze the impact of GP appointment accessibility on pediatric healthcare utilization in England.

Main Methods:

• Analysis of administrative hospital data for 9.5 million children (<15 years) in England (April 2011-March 2012).
• Categorization of GP practices into six access groups based on patient-reported appointment scheduling ease.
• Comparison of emergency department visit and short hospitalization rates across different GP access levels.

Main Results:

• Children with the highest GP access were 9% less likely to visit an ED compared to those with the lowest access.
• This reduction in ED visits was more pronounced for out-of-hours (OOH) care (10% vs 7% during consulting hours).
• No significant difference in short hospitalization rates was observed between the highest and lowest GP access groups.

Conclusions:

• Enhancing GP accessibility could decrease the number of children visiting emergency departments, particularly during OOH periods.
• Short hospitalizations in children appear less sensitive to GP accessibility and may be influenced by other healthcare system factors.
• Improving primary care access is a potential strategy to manage pediatric emergency care demand.