Abstract
Background: Urgent Care (UC) is a branch of medicine that provides immediate medical attention for acute injuries or illnesses within the community. It aims to offer timely medical care for non-life-threatening conditions that require immediate intervention but do not warrant a visit to the emergency department (ED). Urgent Care Centres (UCCs) are staffed by ED-trained general practitioners (GPs), urgent care trainees, and nurses. UCCs operate outside regular hours, providing care to walk-in patients without appointments. While this primary model of care has been implemented in the UK, USA, and NZ, it lacks nationwide implementation in Australia. With an increasing demand for emergency care, UCCs have emerged as an alternative to alleviate patient burden on ED.
Objective: This study aimed to evaluate the effectiveness of GP-led urgent care centers in reducing the number of ED presentations.
Method: This observational retrospective single-center study was conducted at the Urgent Care Centre in Wentworthville, Sydney, Australia. The UCC was supported and funded by the Ministry of Health, in partnership with the Western Sydney Local Health District (WSLHD) and Primary Health Network (PHN), spanned from September 2021 to May 2022. Data on patient socio-demographic profile, disease patterns, waiting time, duration of stay, discharge time, referral rate, and feedback were collected. A total of 1,629 patients were included in the study. Patients were triaged by UCC nurses and then evaluated by UCC doctors. If necessary, imaging, or other investigations were arranged. Appropriate treatments, such as IV fluids, antibiotics, fracture, or wound management, were provided in adherence to the highest standards of ED care. Finally, patients were discharged home or referred to the ED as needed. Statistical analyses, including specific data calculations and tabulations, were performed using Microsoft Excel. Demographic information was summarized using descriptive statistics, including mode and frequency distribution, for the identified variables.
Results: Within 9 months, out of the total 1629 of patients seen, 1,437 (88%) were successfully discharged, while 192 (12%) were referred to the emergency department. The highest rate of injuries was observed to be open wounds and fractures, accounting for 11% of the cases.
Conclusion: This is the first pilot project in NSW. This study demonstrates the effectiveness of a GP-led urgent care center in reducing the number of ED presentations. Further multi-center studies would be beneficial to assess its feasibility across Australia. This model could serve as a valuable framework for implementing GP-led urgent care in other regions.
Keywords: urgent care, general practitioners, primary health care, emergency presentations.