Convenient primary care and emergency hospital utilisation

Abstract

Participation and utilisation decisions lie at the heart of many public policy questions. I contribute new evidence by using hospital records to examine how access to primary care services affects utilisation of hospital Emergency Departments in England. Using a natural experiment in the roll out of services, I first show that access to primary care reduces Emergency Department visits. Additional strategies then allow me to separate descriptively four aspects of primary care access: proximity, opening hours, need to make an appointment, and eligibility. Convenience-oriented services divert three times as many patients from emergency visits, largely because patients can attend without appointments.

Keywords: Access; Emergency care; Primary care; Utilisation decisions.