Can increased primary care access reduce demand for emergency care? Evidence from England's 7-day GP opening

Dolton, Peter and Pathania, Vikram (2016) Can increased primary care access reduce demand for emergency care? Evidence from England's 7-day GP opening. Journal of Health Economics, 49. pp. 193-208. ISSN 0167-6296

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Abstract

Restricted access to primary care can lead to avoidable, excessive use of expensive emergency care. Since 2013, partly to alleviate overcrowding at the Accident & Emergency (A&E) units of hospitals, the UK has been piloting 7-day opening of General Practitioner (GP) practices to improve primary care access for patients. We evaluate the impact of these pilots on patient attendances at A&E. We estimate that 7-day GP opening has reduced A&E attendances by patients of pilot practices by 9.9% with most of the impact on weekends which see A&E attendances fall by 17.9%. The effect is non-monotonic in case severity with most of the fall occurring in cases of moderate severity. An additional finding is that there is also a 9.9% fall in weekend hospital admissions (from A&E) which is entirely driven by a fall in admissions of elderly patients. The impact on A&E attendances appears to be bigger among wealthier patients. We present evidence in support of a causal interpretation of our results and discuss policy implications.

Item Type: Article
Schools and Departments: School of Business, Management and Economics > Economics
Subjects: H Social Sciences > HJ Public Finance
R Medicine > RA Public aspects of medicine > RA0960 Medical centres. Hospitals. Dispensaries. Clinics Including ambulance service, nursing homes, hospices
Depositing User: Vikram Pathania
Date Deposited: 20 May 2016 06:34
Last Modified: 16 Dec 2017 02:00
URI: http://sro.sussex.ac.uk/id/eprint/61074

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