General practitioners' perceptions on the introduction of a primary care service in the Accident and Emergency Department (St. Luke's Hospital, Malta)

Abstract

Hospital services are the largest component of national health care expenditure and their cost impacts everyone. According to the latest survey carried out recently (as issued on the Sunday Times, Aug 31, 2003), it was indicated that 78% and 73% of the population use the Accident and Emergency (A & E) department and health centres respectively. This confirms the high turnover of patients attending casualty (110,000 per year), as well as those who attend the health centres (over 1.1 million per year). The demand for the Accident and Emergency (A&E) service is increasing annually, however one questions, out of so many patients attending the A & E department, how many of these are true emergencies and how many could have been treated at a health centre or by a private General Practitioner (GP)? It has been noted that on many occasions, a large percentage of patients attending the A & E department are presenting with conditions which could have been seen and treated by private GPs or GPs working at the health centers. From the perspective of the A&E service, this has been portrayed as problematic, contributing to 'inappropriate' utilization of hospital resources and expertise, prolonged waiting times and increased stress on the A & E staff. A study suggests that by employing general practitioners in the A&E department to treat patients with primary care problems may be beneficial to the health department.