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984 Evaluation of the effectiveness of a Welsh Physician Response Unit (PRU) at reducing ED footfall; identifying the rates and reasons for ED attendance after discharge at the scene by a PRU
  1. Fiona Andrew1,
  2. Kosta Morley2
  1. 1Cardiff University
  2. 2The Grange University Hospital


Aims/Objectives/Background The Aneurin Bevan University Health Board (ABUHB) Physician Response Unit (PRU) aims to alleviate the pressure on its emergency departments (EDs) through the provision of physician-led community emergency medicine. An increasingly common prehospital model, the PRU brings the ED doctor to the patient with the aim of reducing the number of 999-callers requiring an ED visit. However, with no published ED follow-up studies amongst UK PRU services, how can physicians and commissioners ensure that PRU discharge in the community is synonymous with a prevented ED attendance?

This study aims to be the first to follow up and identify the proportion of patients attending the ED within 7 days of discharge by a PRU and to establish the factors associated with attendance.

Methods/Design Pilot retrospective observational analysis of 3 months of adult patients discharged by the ABUHB PRU in 2020. ED database searches identified patients attending the ED within 7 days of discharge. Patients were contacted for a scripted telephone satisfaction survey and responses alongside demographics were analysed for associations with ED attendance through odds ratios (OR), relative risk (RR) and Pearson’s chi-squared tests.

Results/Conclusions The 7-day ED attendance rate was 11.7% (12 out of 103 patients). Two thirds presented due to continued symptoms. Nine patients were admitted. Male sex was associated with an increased likelihood of ED attendance (OR=4.067, 95% CI 1.134–14.587, p=0.023) alongside being in the 40–50 and 51–61 age groups (RR 3.93; 95% CI 1.153–13.327 and RR 8.25; 95% CI 3.556–19.139 respectively). The modal satisfaction rating for overall experience with the PRU was ‘very satisfied’ but no association between satisfaction level and ED attendance was identified (p=0.210) despite a 94% response rate.

This study reinforces perceptions that the PRU is effective at delivering definitive care in the community whilst paving the way for future follow-up studies amongst other PRU services.

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