Utilization of emergency services in primary care clinics

Utilization of emergency services (ES) by primary care physicians was retrospectively surveyed in a regional hospital. Referrals and self-referrals from an urban university clinic, a community clinic, a smalltown clinic and a rural community clinic were included. There was an average referral and self-referral rate of 38/100/year. Both referrals and proportion of self-referrals were inversely related to the distance between primary care clinic and the ES. Most referrals and self-referrals occurred on week-days during the hours primary care clinics were open. About 13% of ES visits resulted in hospitalization, with no significant differences between the different types of clinic or the hour of referral. We conclude, that hospital-based ES are utilized not only to provide emergency care, but also as support systems for primary care clinics, especially those readily accessible to the ES.