ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 67
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Clinician and patient consensus for urgency and safety to
wait for assessment in primary care after-hours: Crosssectional survey results
Dr Katelyn Barnes1,2, Caitlin Arpel2, Prof Kirsty Douglas1,2
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Act Health Directorate, 2School of Medicine and Psychology, Australian National University
Rationale
Approximately 40% of Australian emergency department (ED) presentations after-hours are classified
as ‘avoidable’. Efforts to reduce ED presentations have focused on shifting patients into primary
care. However, primary care is already managing the largest proportion of after-hours presentations,
indicating potential inefficiencies of after-hours services use. Differences between patient- and
clinician-perceived urgency of an issue may be driving ‘inappropriate’ presentations. We investigated
the level of agreement between patient and clinician perceptions of urgency and safety to wait for an
assessment at primary care after-hours services in Canberra.
Methods
Cross-sectional surveys voluntarily completed by patients and then their clinicians at after-hours
medical services were completed in May/June 2019. Single categorical responses captured patient
and clinician ratings of urgency and safety to wait for assessment. Agreement in ratings was measured
by Fleiss kappa.
Results
In all, 888 matched surveys (representing 31% of all presentations) showed that overall interobserver
agreement between patients and clinicians on the urgency of presentations was slight (Fleiss kappa =
0.166; 95% CI: 0.117, 0.215; P
