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Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis
Authors:William Whittaker  Laura Anselmi  S?ren Rud Kristensen  Yiu-Shing Lau  Simon Bailey  Peter Bower  Katherine Checkland  Rebecca Elvey  Katy Rothwell  Jonathan Stokes  Damian Hodgson
Abstract:BackgroundHealth services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends.Extended access (evening and weekend opening) is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators.ConclusionsThe study found that extending access was associated with a reduction in emergency department visits in the first 12 months. The results of the research have already informed the decision by National Health Service England to extend primary care access across Greater Manchester from 2016. However, further evidence is needed to understand whether extending primary care access is cost-effective and sustainable.
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