A comparison of patient self-referrals and general practitioner referrals to the emergency department in Ireland during the COVID-19 pandemic: secondary data analysis of the “Better Data, Better Planning” study

BACKGROUND: Internationally crowding in Emergency Departments (ED) has become a public health issue. In Ireland, primary care is centred around General Practitioners who can refer patients with acute illnesses or injuries to the ED. Patients can also choose to go directly to the ED if they require emergency care and self-referrals to the ED have been rising in recent years. AIM: The study aims to describe the demographic and clinical characteristics of patients who self-referred compared to patients referred by GPs in Irish EDs during the COVID-19 pandemic. METHODS: This was a secondary data analysis of a cross-sectional, multi-centre study describing Irish ED utilisation; the Better Data, Better Planning (BDBP) Study. Descriptive comparisons were made between GP referrals to the ED and self-referrals in relation to; demographics, clinical data, healthcare utilisation, service awareness and other factors, with data being analysed in SPSS. RESULTS: Demographic differences were minimal however significant differences were observed between GP referrals and self-referrals for; types of clinical presentations (p < 0.05), duration of complaint (p < 0.001), awareness of other services (p < 0.05), need for reassurance (p < 0.001), acquiring a second opinion (p < 0.05) and utilisation of GPs over the year (p < 0.05). CONCLUSION: Demographics were similar between GP referrals and self-referrals to the ED however significant behavioural and clinical differences were observed across groups. Awareness of these factors could be useful for policymakers in service planning for ED crowding generally and also more specifically in the event of a future pandemic.