Reducing Emergency Department demand through expanded primary healthcare practice.

Evaluating the factors that influence the choice made by patients between ED and primary healthcare for acute illness

Grant ID: EMPJ-301R23-2015

Project Summary

Patient demand on Emergency Departments (EDs) is rising by over 3% per annum contributing to congestion. ED congestion is known to be associated with poor health outcomes and reduced efficiency; the latter is characterised by increased waiting time, length of stay and ambulance diversion. Even though the National Emergency Access Target (the four-hour rule) has reduced the level of access block, initiatives to reduce ED demands have not had significant effect to date.
Previous research undertaken by the emergency health research group at QUT has described in detail the increases in demand and has identified some contributing factors. Our research highlighted reduced access to primary healthcare is one important factor associated with increased ED demand.

The aim of this project is built on our earlier work investigating factors that influence the choice made by patients between ED and primary healthcare for acute illness, and to thus identify viable primary healthcare alternatives for diverting ED patients so as to reduce ED demand. This project will provide the necessary evidence base to subsequently develop a NHMRC grant application to trial a national model of expanded primary healthcare practice to reduce ED demand. Importantly, this project will facilitate better integration and knowledge exchange between existing primary and secondary health sectors in Queensland through the stakeholder involvement.



- Toloo, G.S., Hettiarachchi, R., Lim, D., and Willson, K. (2022), Reducing Emergency Department demand through expanded primary healthcare practice: Full report of the research and findings. Queensland University of Technology, Brisbane, Australia.

- Willson, K.A., Lim, D., Toloo, G.S., FitzGerald, G., Kinnear, F.B. and Morel, D.G., 2022. Potential role of general practice in reducing emergency department demand: A qualitative study. Emergency Medicine Australasia.

- Toloo, G., Lim, D., Chu, K., Kinnear, F.B., Morel, D.G., Wraith, D. and FitzGerald, G., 2021. Acceptability of emergency department triage nurse's advice for patients to attend general practice: A cross‐sectional survey. Emergency Medicine Australasia.

- Toloo, G., Bahl, N., Lim, D., FitzGerald, G., Wraith, D., Chu, K., Kinnear, F.B., Aitken, P. and Morel, D., 2020. General practitioner‐type patients in emergency departments in metro North Brisbane, Queensland: A multisite study. Emergency Medicine Australasia, 32(3), pp.481-488.

- Romeo, Michele, Money, Jennifer, Toloo, Ghasem (Sam), & Lim, David (2020) Effectiveness of general practice availability in reducing avoidable utilisation of emergency departments: A rapid review of the literature. Queensland University of Technology, Australia.


- Toloo, G. GP-type patients in emergency departments, Redcliffe Hospital Education Round on 22 Oct 2020.


- Toloo, G., Morel, D., FitzGerald, G., Dec 2018. Reducing emergency department demand through expanded primary healthcare. Introducing and promoting the research to Special Interest Group of the Public Health Association of Australia - PHCSIG Newsletter: Vol 8(2): p. 3.


Amount Awarded


Grant Scheme


Principal Investigator:
Dr Douglas Morel

Co Investigators:
Prof Gerard FitzGerald
A/Prof Peter Atiken
Dr David Lim
Dr Sam Toloo
Dr Fran Kinnear
Dr Colin Myers
A/Prof Kevin Chu


Collaborating Institutions

CONTACT US +61 7 3720 5700 Suite 1B, Terraces, 19 Lang Parade, Milton Qld 4064