Rates of general practitioner attendance following paramedic-to-general practitioner referral in Victoria, Australia

Abstract

Introduction Previous evaluations of paramedic-to-general practitioner (GP) referrals have focused on subsequent emergency department presentations or ambulance representations; however, we aimed to appreciate patient adherence where paramedics have recommended follow-up with a GP. Methods This was a prospective cohort study of adult patients in Victoria, Australia, who were referred to a GP by a paramedic over a 28-day period in June 2021. Patients were then contacted within five days to determine subsequent GP attendance. Results Of the 752 patients who met the inclusion criteria, 47% (n = 353) consented to participate. At the time of the survey, 65% of patients had followed up with their GP, with a further 15% booked in for a future appointment. Factors associated with the increased adjusted likelihood of the participant following up with a GP after paramedic referral included female gender (adjusted odds ratio [AOR] 2.21, 95% confidence interval [CI] 1.22–3.99, P = 0.009) and those given a specific time frame for the follow-up appointment by the paramedics (AOR 3.98, 95% CI 2.26–7.02, P < 0.001). Participants who presented to ambulance services overnight were less likely to follow up with a GP (AOR 0.34, 95% CI 0.17–0.68, P = 0.002). The three most commonly stated reasons for not following up with a GP were that the patient felt it was unnecessary (n = 48), their regular GP was unavailable (n = 33) or they had followed up with an alternative service (n = 31). Conclusion Most patients who are referred to a GP by attending paramedics will follow up with a GP within 72 h. The most common barrier to GP follow-up is the patients’ perception that follow-up is unnecessary.