{
  "abstract": "Aims and Objectives Despite limited evidence of benefit to patients and health systems, a policy of redirecting low-acuity ED (Emergency Department) patients to primary care has been adopted by healthcare systems internationally, aiming to reduce ED overcrowding. As patients experiencing socioeconomic deprivation have poorer access to primary healthcare, there is a risk that they are both more likely to present with low acuity conditions, and be less likely to access the services to which they are redirected. Understanding how redirection policies impact different groups is important; to inform system design and ensure these strategies are implemented in such a way that patients are redirected to accessible services.Method and Design A multi-centre retrospective cohort study of every presentation to three EDs in the West of Scotland from 1st November 2023 to 31st December 2024. The primary outcome was redirection to primary care or other services from ED triage. Mixed-effects logistic regression was used to determine the association between socioeconomic status (as decile of Scottish Index of Multiple Deprivation of residence) and redirection. The analysis was adjusted for the confounders of age, sex, and distance from residence to hospital.Abstract 4125 Table 1Results of logistic regression for the association between socioeconomic status and redirection from emergency department triage Univariable Multivariable Characteristic RR(95% Cl ) p-value aRR(95% Cl ) p-value Age 0.99 (0.99-0.99) <0.001 0.99 (0.99-0.99) <0.001 Scottish Index of Multiple Deprivation 10 (least deprived) Reference Reference 9 1.11 (1.00, 1.24) 0.052 1.10 (0.96, 1.25) 0.180 8 1.10 (0.98, 1.23) 0.095 1.07 (0.93, 1.23) 0.338 7 1.21 (1.08, 1.36) 0.001 1.18 (1.03, 1.36) 0.017 6 1.31 (1.18, 1.46) <0.001 1.27 (1.11, 1.45) <0.001 5 1.24 (1.13, 1.38) <0.001 1.20 (1.05, 1.36) 0.005 4 1.30 (1.18, 1.43) <0.001 1.26 (1.11, 1.43) <0.001 3 1.31 (1.19, 1.44) <0.001 1.24 (1.10, 1.41) <0.001 2 1.41 (1.29, 1.54) <0.001 1.31 (1.17, 1.47) <0.001 1 (most deprived) 1.38 (1.26, 1.50) <0.001 1.28 (1.14, 1.43) <0.001 Sex Male Reference Reference Female 0.98 (0.94, 1.03) 0.483 1.01 (0.96, 1.05) 0.770 Distance of residence from Emergency Department (per 10km) 1.01 (1.00-1.02) 0.011 0.96 (0.94-0.98) <0.001 Cl - Confidence Interval, aRR-Adjusted Relative RiskResults and Conclusion Over the study period, there were 381,344 presentations. Twenty patients did not have redirection status coded, leaving 381,324 for analysis, of which 7,742 (2.0%) were redirected to other services. Compared to those in the least deprived areas, patients residing in the most deprived areas were significantly more likely to be redirected (Relative Risk 1.28; 95% confidence interval 1.14-1.43) ( table 1). The most deprived patients are more likely to be redirected to other services from triage. Healthcare policymakers should consider these results in the design of redirection policies, understanding that patients experiencing socioeconomic deprivation may be unable to access the services to which they are redirected, and this indeed may be a contributory factor to the initial low-acuity presentation.",
  "authors": [
    {
      "affiliations": [
        "Queen Elizabeth University Hospital, Glasgow"
      ],
      "name": "Ryan McHenry"
    },
    {
      "affiliations": [
        "Emergency Department, University Hospital Hairmyres"
      ],
      "name": "Marion Campbell"
    },
    {
      "affiliations": [
        "University of Glasgow"
      ],
      "name": "David Blane"
    },
    {
      "affiliations": [
        "Emergency Medical Retrieval Service, ScotSTAR"
      ],
      "name": "Alasdair Corfield"
    },
    {
      "affiliations": [
        "Emergency Department, University Hospital Crosshouse"
      ],
      "name": "David Chung"
    }
  ],
  "title": "4125 The association between socioeconomic status and redirection of low-acuity patients from emergency department triage: a multi-centre, retrospective cohort study",
  "uid": "e21d9e99-5732-5794-abc2-489a65aca2eb"
}