Self-referral trends to a virtual emergency department following initial presentation: A retrospective exploratory analysis.

Objective: The Victorian Virtual Emergency Department (VVED) provides emergency care for patients across Victoria, Australia with non-life-threatening concerns. This study aims to explore subsequent self-referral patterns of patients after initial presentation to the VVED.

Methods: A retrospective cohort study was conducted in 42,921 VVED patients between October 2020 and June 2024. Subsequent self-referral rates among VVED patients who were initially referred through a health care provider (HCP) referral pathway were compared to those who self-referred upon their first presentation. Descriptive statistics and multivariable logistic regression modelling were used.

Results: Patients were more likely to self-refer on their second presentation if they self-referred on their first presentation (88 % vs 40 %; p < 0.001). Multivariable logistic regression analyses showed significantly lower odds of subsequent self-referral in all HCP referral pathways compared to the self-referral group. Patients referred through pathways without an HCP present had higher odds of subsequent self-referral than those referred via pathways with a HCP present (OR=1.19, 95 % CI: 1.10-1.28).

Conclusions: Patients who self-refer to the VVED initially are more likely to continue self-referring to the service. Further research is needed to explore factors that may enhance the likelihood of self-referral to virtual emergency care services.