Study finds clear link between clinic accessibility and emergency room visits

Access to health care and the usage of emergency departments are popular topics in the news.

David Jones, a graduate student in the University of Alberta's School of Public Health, along with Linda Carroll, professor in the School of Public Health, and Leonard Frank, executive director of the Leduc Beaumont Devon Primary Care Network, recently completed a study that examined whether or not there was a clear association between the number of visits to the emergency department and the availability of an after-hours care clinic in Leduc, Alberta.

Jones took into account 28 months worth of data with a population size of about 20,000 people. The statistics took into consideration non-urgent and semi-urgent patient visits to the Leduc Hospital emergency department for 14 months prior to the opening of an after-hours clinic and 14 months after the clinic opened.

Based on this study, "there was a 40 per cent reduction in semi-urgent patients using the emergency department," said Jones.

Semi-urgent patients are classified, for example, as those that have suffered minor trauma, or who have abdominal pain or acute joint swelling. Non-urgent patients typically suffer from ailments such as nasal congestion or chronic low back pain, says the Canadian Triage and Acuity Scale.

The after-hours clinic is operated by the Leduc Beaumont Devon Primary Care Network, a joint partnership between participating family physicians in the area and Alberta Health Services, said Frank. "Primary care networks are based on the idea of finding local solutions to local needs and this clinic is a tremendous example of that."

The family physicians who work at the Leduc Hospital noted that increasingly patients were being seen in the emergency departments who could have been better served in a primary care setting such as the after-hours clinic. "Having a more appropriate use of resources was important to the physicians in trying to best serve their patients," said Frank.

Jones agrees. "These two types of patients, it has been argued in the literature, can be well served in a physician's office rather than an emergency department, but they contribute to emergency department overcrowding."

The after-hours clinic provided access to a physician between the hours of 6 p.m., Monday through Thursday.

"This study provides further evidence that offering these services can positively impact emergency department use, and while we have to be careful about population size and intervention, we did see a definite reduction in emergency room visits," said Jones.