Objectives-To compare outcome and costs of general practitioners, senior house officers, and registrars treating patients who attended accident and emergency department with problems assessed at triage as being of primary care type.
Design-Prospective intervention study which was later costed.
Setting-Inner city accident and emergency department in south east London.
Subjects-4641 patients presenting with primary care problems : 1702 were seen by general practitioners, 2382 by senior house officers, and 557 by registrars.
Main outcome measures-Satisfaction and outcome assessed in subsample of 565 patients 7-10 days after hospital attendance and aggregate costs of hospital care provided.
Most patients expressed high levels of satisfaction with clinical assessment (430/562 (77%)), treatment (418/557 (75%)), and consulting doctor's manner (434/492 (88%)). Patients'reported outcome and use of general practice in 7-10 days after attendance were similar : 206/241 (85%), 224/263 (85%), and 52/59 (88%) of those seen by general practitioners, senior house officers, and registrars respectively were fully recovered or improving (khi2=0.35, P=0.840), while 48/240 (20%), 48/268 (18%), and 12/57 (21%) respectively consulted a general practitioner or practice nurse (khi2=0.51, P=0.774).
Excluding costs of admissions, the average costs per case were £19.30, £17.97, and £11.70 for senior house officers, registrars, and general practitioners respectively.
With cost ...
Mots-clés Pascal : Médecin généraliste, Accident, Urgence, Service hospitalier, Soin santé primaire, Economie santé, Analyse coût efficacité, Homme
Mots-clés Pascal anglais : General practitioner, Accident, Emergency, Hospital ward, Primary health care, Health economy, Cost efficiency analysis, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0289510
Code Inist : 002B30A05. Création : 199608.