Assessing urgent medical cases in general practice: development of the ACUTE-GP instrument

BACKGROUND: General practitioners (GPs) play a crucial role in managing urgent medical cases, yet data on the nature and urgency of such cases in primary care are limited. Existing research focuses mainly on emergency departments (EDs) and out-of-hours services, underestimating acute care delivered by GPs. AIM: To develop and psychometrically test an instrument designed to comprehensively assess urgent medical cases in general practice. DESIGN & SETTING: Cross-sectional survey in German practices, with GPs documenting urgent cases during a self-selected workday. METHODS: The ACUTE-GP instrument was developed, piloted, and finally tested in a cross-sectional survey. The final tool comprises ten items capturing physical, psychological, administrative, and therapeutic aspects. Psychometric properties were examined using principal component analysis to assess the factorial structure, and reliability was evaluated using the Kuder-Richardson coefficient (KR-20). RESULTS: Fifty-eight GPs assessed 572 consultations. Of these, 342 (60%) were managed entirely within the practice, with 60% classified as urgent or emergencies. Emergency consultations showed the highest mean number of aspects (mean = 4.6), followed by non-urgent (3.9) and urgent ones (3.2). The instrument demonstrated satisfactory internal consistency (KR-20 = 0.621) and content validity. CONCLUSION: GPs provide substantial acute care, challenging the perception that urgent cases necessarily require ED management. Further validation of the ACUTE-GP instrument in diverse healthcare settings and its integration into routine practice are recommended.