• Colleen Cheek, Penny Allen, Lizzi Shires, Denise Parry, and Marielle Ruigrok.
• Rural Clinical School, University of Tasmania, Burnie, Tasmania, Australia.
• Emerg Med Australas. 2016 Apr 1; 28 (2): 145-52.

ObjectiveTo explore GP-referrals and self-referrals to EDs and factors associated with patients seeking low-acuity care at ED.MethodRetrospective analysis of all ED presentations to Mersey Community Hospital and North West Regional Hospital (Tasmania) between 1 January 2009 and 31 December 2013. Cross-sectional survey of patients presenting to the EDs for care triaged as low-acuity.ResultsThere were 255,365 ED presentations in the retrospective data: 11,252 (4.4%) GP-referrals and 218,205 (85.4%) self-referrals. At ED 49% of GP-referrals were triaged ATS 4 or 5 and 35% of self-referrals were triaged ATS 1-3. There were 138 (84.2%) low-acuity patients who completed the survey; predominantly, all attended for acute injury or illness. Single point-of-care convenience was most commonly selected (71%) as a reason for attending ED.ConclusionsOver 85% of patients who seek emergency care in this region self-refer, so understanding health-seeking behaviour is important. Most low-acuity patients are acutely injured or unwell, and the decision to go to ED is based on their perception of accessibility of expertise aligned with their need. The term 'GP-type' is misleading in this context and should not be used. Providing low-acuity care in parallel with providing a specialised emergency service meets the needs of the local community and is likely to be the lowest cost model in a regional and rural area. Funding models must reflect the actual cost of delivering this important service rather than presentation types.© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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