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Impact of a GP cooperative on lower acuity emergency department attendances
  1. Fergus D O'Kelly1,
  2. Conor Teljeur1,
  3. Ian Carter2,
  4. Patrick K Plunkett2
  1. 1Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
  2. 2St. James's Hospital, Dublin, Ireland
  1. Correspondence to Professor Fergus D O'Kelly, Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland; feokelly{at}


Background In 1998 ‘Dubdoc’, Ireland's first out-of-hours general practice emergency service, opened in an outpatient suite in St James's Hospital with a separate entrance 300 m from the emergency department (ED). Dubdoc was established with the aim of providing an easy access out-of-hours service for ambulatory patients of those doctors supplying the service.

Aim To determine whether ED attendances for patients in the lower acuity triage categories 4 and 5 have changed since the establishment of ‘Dubdoc’.

Methods A retrospective review of all attendances at the ‘Dubdoc’ service was compared with attendances at the ED for triage categories 4 and 5 of the same hospital over a 9-year period (1999–2007 inclusive) for equivalent times of day.

Results ED attendances during ‘Dubdoc’ hours have decreased as a proportion of all attendances for triage categories 4 and 5. ED attendances for triage categories 4 and 5 fell substantially during the study period.

Conclusions Although the presence of the ‘Dubdoc’ service has resulted in a decrease in ED attendances for triage categories 4 and 5, this is a minor proportion of the overall decrease in attendances in this group of patients.

  • Doctors in PHC
  • comparative system research
  • emergency care systems
  • prehospital care, doctors in PHC

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  • Funding CT was funded by the Health Research Board of Ireland through the HRB Centre PRIMCARE under grant 1139.

  • Competing interests FDO'K is a member of Dubdoc. PKP is Clinical Director in Emergency Medicine at St James's Hospital. Both were involved in the initial setting up of DubDoc.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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