How sensitive are avoidable emergency department attendances to primary care quality? Retrospective observational study.

Abstract

BACKGROUND: Improvements in primary care quality are often proposed as a solution to rises in emergency department (ED) attendances. However, there is little agreement on what constitutes an avoidable attendance, and the relationship between primary care quality and ED demand remains poorly understood. OBJECTIVE: To estimate the size of the associations between primary care quality and volumes of ED attendances classified as avoidable. METHODS: Retrospective observational study of all attendances at EDs in England during 2015/2016, applying three definitions of avoidable attendance. We linked practice-level counts of attendances to seven measures of primary care access, patient experience an..