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Extended Latrobe Valley Injury Study (ELVIS)

The Extended Latrobe Valley Injury Study, better known as ELVIS, is a combined effort between the Monash University School of Rural Health , the Monash University Accident Research Centre, and the Central West Gippsland Division of General Practice.

Aims

ELVIS had two main thrusts. They were:

  1. To establish a health data collection and research network amongst the General Practitioners in the Central West Gippsland Division of General Practice.
  2. To document the injuries presenting to the Latrobe Valley general practitioners for a year; to recommend improvements in the management of injuries in our practices, and to identify the factors which patients indicate influence their decision to attend general practice with an injury rather than the emergency department of the local hospital.'

Data Collection Methods

The data was collected on a questionnaire handed to the patients either by the receptionists, sisters or the GP themselves when a patient presents to the practice with an injury. The questionnaire obtains from the patient a description of how the injury occurred, and asks the doctor to describe the nature, location, and intent of the injury, along with what level of treatment was required.

General Information about ELVIS

The project recruited 61 out of the 63 General Practitioners within the Latrobe Valley into the study. The data collection started on the 7th November 1994, and collected data for one year. At the same time, a similar data collection is being run by the Victorian Injury Surveillance System (VISS) in the emergency departments of the Latrobe Regional Hospital. This will enable us to have a complete picture of all medically treated injuries that occur in the Latrobe Valley for the duration of ELVIS. A ratio of emergency department injury presentations to general practice injury presentations was able to be calculated, allowing us to estimate the level of injury presenting to general practice in the future when ELVIS is finished.

Latest results/ findings

During the course of the year, we collected 6,002 questionnaires. Our auditing suggests that this is around 77% of the true number of injuries seen. The VISS data collection collected about 8,000 questionnaires for the same time frame, but have a higher collection rate, about 88%. Thus the current estimate for the ratio between the two settings is close to 1:1 (actual estimate 0.83 GP injury presentations to every emergency department injury presentation). This estimate is considerably lower than estimates made before the study started, which were in the 2:1 to 3:1 range. There are many reasons for this difference, but the most important is that in the Latrobe Valley there are two emergency departments serving a relatively small population, allowing greater access for treatment than in other areas, particularly urban areas. In addition, nearly all General Practices in the Latrobe Valley operate on 9 to 5 hours, with only 2 open later, and none past 8pm. Therefore an injuries that occur outside business hours will need to be seen in an emergency department, or wait until the next day for treatment.

Not surprisingly, there have been some differences observed between the nature of injuries seen in general practice compared to those seen at the emergency department. More sprains and strains and less fractures were seen in ELVIS, and a higher proportion of females have been seen in ELVIS as well. Despite this, there are considerably more males treated for injuries than females (ratio1.5:1), especially in the younger age groups (ratio 2:1). A higher proportion of children (U15 years of age) and elderly (over 70 years) was seen in ELVIS compared to VISS. Injuries that occured in an educational setting and in the workplace were more likely to be seen by a GP. When asked to nominate the reason for seeing a GP rather than going to the hospital, most patients answered that they preferred to see a doctor they knew, with the injury not being serious enough the second most common reason.

There have also been considerable differences in the nature of injuries documented between the four towns in the study (Moe, Morwell, Traralgon and Churchill), between practices, and even between individual doctors within the practices. A more detailed analysis of these trends is currently being performed.

Participants

GPs participating in the project included:

Dr A R BARNES | Dr K BIRKS | Dr J L BRAGG | Dr P BROUGHAM | Dr J BROWN | Dr J BURAS | Dr P K  | HABRA | Dr S CLARKE | Dr P COUGHLAN | Dr R CRISTOFARO | Dr S DEED | Dr RW DIGBY | Dr F EDWARDS | Dr R ELMORE | Dr B EU | Dr P M FIELD | Dr B FITZGERALD | Dr R FITZGERALD | Dr M FOSBURY | Dr F GIBB | Dr A GRAHAM | Dr S GRIGOLEIT | Dr R H HALL | Dr W HAYES | Dr C HRSTIC | Dr A HUGHES | Dr K INNES | Dr T JABLONSKI | Dr J KEE | Dr R M KUZEFF | Dr C LAMPEL | Dr R LURIE | Dr E A MARROW | Dr M MARSHALL | Dr H McCORMICK | Dr D MCCULLOCH | Dr M MCKELVIE | Dr K MULLIGAN | Dr D J MURPHY | Dr G MURRAY | Dr S NG | Dr K NOAKES | Dr T NORWOOD | Dr J PAYNE | Dr C PERERA | Dr C PERRY | Dr B ROONEY | Dr B SHARMA | Dr V S SKANDARAJAH | Dr V SPECK | Dr H STANLEY | Dr N L STEER | Prof R STRASSER | Dr L THURMAN | Dr I C WEBB | Dr A N WOODWARD

For further information contact:

The School of Rural Health