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I find the methodology for this paper to contain a significant flaw in
that the triage criteria used to determine suitability for the GP unit
contain a requirement that the patient will need minimal additional
resources for them to be processed. It is hardly surprising therefore that
the post intervention analysis sees fewer additional resources
subsequently spent on this group with the associated savings.
In addition, it is contradictory to say that under the cost data the
ED cost per patient went up due to "some shift in patient mix after
triage" but in the discussion to claim that it was unlikely that the cost
differences were explained by differences between the two populations.
Finally, the rise in patient numbers of around 60% in 5 years
represents a phenomenal failure to contain the overall cost of emergency
care provision, despite the quoted lower costs per patient for the GP
unit. The conclusion that such a model represents "dominance" is therefore