This research presentation was given by Mr Shaddy Hanna at the RACGP Annual Conference (GP19) at the Adelaide Convention Centre, on 26 October 2019.
Hanna S, Tam CWM, Knight A, Zhao L, Ban L, Pellizzon B, Parks J. The ED2GP for women study: understanding lower follow-up rates amongst older women. RACGP Annual Conference (GP19). Adelaide Convention Centre, Adelaide Australia. 2019 October 26.
Abstract
Background:
Older women were observed to have substantially lower general practitioner (GP) follow-up rates after an emergency department (ED) discharge compared to men (67% vs 90%, Watson et al. 2017).
Aims:
To describe and understand how older women seek GP follow-up after an ED visit.
Method:
In this predominantly qualitative study, women aged 65 years and older were recruited from a suburban ED in Fairfield NSW. Interviews with structured and semi-structured questions were conducted during the ED visit, and again seven days later by telephone. Data collected included beliefs, attitudes, intentions, and experiences of GP follow-up. Grounded theory was used to construct a potential explanatory model of follow-up behaviours.
Results:
Of the 100 women recruited, 64% had attended GP follow-up by day seven. The perceived cost and benefit of GP follow-up emerged as a useful model to understand how factors influenced follow-up behaviour. Perceived costs included inconvenience caused to self, access to transport options, the perceived inconvenience posed to others, and the availability of the patient’s GP. Perceived benefits included previous experiences with the healthcare system, pre-existing health-seeking behaviours, and ED messaging.
Discussion:
Our model suggests that follow-up rates could be potentially improved by increasing the perceived benefit of GP follow-up at the point of ED discharge, in addition to addressing the costs, or the typical “barriers”. Approaches might include ensuring that discharge instruction given from the ED are motivating, clearly communicated, and given in the company of family or friends with whom the patient is dependent.
References:
Watson, B, Tam, C, Pellizzon, B, Ban, L, Doan, H (2017) General practitioner follow-up in older patients after an emergency department admission. Aust Fam Physician 46, 521-526.
