Emergency department visits for minor conditions – by doctor continuity

Influence of continuity on emergency department visits for minor conditions. (see data definition)

What do you see?

  • Are there differences in ED visit rates for minor conditions in the urban zones (Calgary and Edmonton) compared to the more rural zones (North, Central, South)? What might account for these differences?
  • How do ED visit rates for minor conditions differ for patients who see one family doctor for most of their visits (i.e., ‘high continuity’) compared to patients who see multiple family doctors (i.e., ‘low continuity’)?

Whether you’re a patient, provider, or health system administrator, thinking about why these differences might exist can start conversations and lead to solutions for improved quality of healthcare.

*Data courtesy of Alberta Health Services and Alberta Health

Understanding this chart

‘Continuity’ refers to the strength of the relationship between a patient and their main family doctor. Continuity is called ‘high’ when more than 80 per cent of a patient’s family doctor visits are to a single main family doctor. Continuity is called ‘low’ when less than 50 per cent of a patient’s family doctor visits are to a single main family doctor. There are many things that can affect continuity.

In general, patients who have a strong relationship to their main family doctor (‘high’ continuity) tend to have lower visits to the ED for conditions that can be treated by a family doctor in their office. Patients with minor conditions often experience long wait times in the ED. If they have a strong relationship with their main family doctor, they will be more likely to call for an appointment on short notice rather than face a long wait in the ED. Good short notice access to a family doctor for non-urgent or minor conditions can keep wait times in the ED down and allows ED resources to be used for patients with more urgent conditions that may need a hospital stay.

In PCNs that are mainly rural, family doctors often work shifts in the ED and will see their patients with minor conditions in the ED rather than in their clinic. This helps strengthen the relationship between the patient and their family doctor.

Considerations when reviewing the results

  • Does not include visits to urgent care centres.
  • This measure includes weekend days as well as weekdays. It is possible that the results mainly represent patient visits during the weekend when their family doctor office is closed.

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. The information in this chart can be used as input to think and have conversations about primary healthcare in Alberta using the lens of the dimensions of quality shown on the right:

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Dimensions of Quality

  • Acceptability
  • Accessibility
  • Appropriateness
  • Effectiveness
  • Efficiency
  • Safety