Emergency and primary care at a Melbourne hospital: reasons for attendance and satisfaction

The reasons for attendance, presenting health problems, functional status, pain and severity, and satisfactionwith emergency and primary care were examined using routinely collected data and an interviewer-assistedsurvey of patients. Patients attended, mostly after hours, because they believed their health problems requiredhospital-based management. GPs referred for admission and further evaluation. Ethnicity, employment status,gender and age contributed to differences in access, morbidity and pain scores. Pain scores, functional statusand English language skills influenced satisfaction.Culturally sensitive hospital- and community-based clinicians are important to promote better services, after-hourscare, referral and triage. It is essential to have appropriate policy and legislation, adequate infrastructureand resources, good communication strategies, telecommunication technology, explicit evidence-basedprotocols for shared care, referral and triage and ongoing training and support for clinicians and consumers.