Patients’ perspectives on a programme to reduce emergency department use for low acuity conditions

• Published in: Proceedings of Singapore Healthcare Vol. 33
• Main Authors: Goh, Wan Xi, Ong, Rebecca Hui Shan, Rebello, Salome Antonette, Goh, Priscilla Sook Kheng, Ahmad, Edris Atikah, How, Choon How, Tiruchittampalam, Mohan, Oh, Hong Choon, Lim, Steven Hoon Chin
• Format: Journal Article
• Language: English
• Published: SAGE Publishing 01.07.2024
• ISSN: 2010-1058; 2059-2329
• DOI: 10.1177/20101058241268494

Background Emergency Department (ED) crowding is a global public health issue with low-acuity ED attendances (LAA) being widely identified as contributors to the issue. A primary care partnership programme, GPFirst, was developed to encourage low-acuity patients to visit their General Practitioners (GP) first, instead of the ED. We utilised a qualitative approach to gain an understanding of participants’ perceptions of GPFirst, their health-seeking behaviours, and explore recommendations for enhancing GPFirst. Methods A qualitative study design, underpinned by an interpretivist approach, was employed. Purposive sampling was used to recruit 12 GPFirst patients from a single tertiary care centre for semi-structured interviews. These interviews were analysed using Braun and Clarke’s reflexive thematic analysis. Results Participants’ age ranged from 25 to 63 years old. Four themes were identified. Firstly, “ perceptions of GPs” , described the variations in participants’ perceptions about GPs. Secondly, “patients’ expectations of GPFirst” , noted the ED fee subsidy and prioritisation of ED care as key expectations of GPFirst. Thirdly, “facilitators and barriers to utilising GPFirst” highlighted the facilitators and barriers that influenced participants’ health-seeking behaviours and finally “recommendations for programme improvement” offered strategies for improvements. Conclusion This is the first qualitative study to examine participants’ perceptions of GPFirst. Recommendations may inform future programme redesign to optimise patient experience and facilitate programme uptake, contributing to overall efforts to reduce ED crowding locally. Future research may consider exploring GPFirst providers’ perspectives to elicit facilitators and barriers in implementation.