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Linking emergency department patients to primary care: phone vs face-to-face interaction
J M Kallis1, J A Gonzalez del Rey, R M Ruddy
1Department of Pediatrics, Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati, OH, USA. jmkallis@aol.com
Insights
Connecting emergency department patients without a primary care provider (PCP) to PCPs by phone is as effective as in-person visits. This phone-based approach also proved more time-efficient for patient compliance.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Access
- Primary Care Integration
Background:
- Emergency departments (EDs) often serve as a critical access point for patients lacking a primary care provider (PCP).
- Establishing timely connections to PCPs is crucial for continuity of care and preventing future ED utilization.
Purpose of the Study:
- To compare patient compliance and time efficiency of two methods for connecting ED patients without a PCP to a primary care provider: phone-based versus face-to-face interaction.
- To evaluate the effectiveness of different PCP assignment strategies in a pediatric ED setting.
Main Methods:
- A prospective observational cohort study was conducted in a large pediatric ED over one year.
- 1,062 eligible patients without a PCP were approached, with 536 enrolled and assigned a PCP via phone or in-person interaction by a nurse practitioner/social worker.
- The primary outcome was appointment compliance, with secondary analysis of time efficiency.
Main Results:
- Of 455 study patients, 33% were contacted by phone and 67% face-to-face.
- Appointment compliance was higher for patients contacted by phone (62%) compared to face-to-face (52%).
- Phone interaction was also found to be more time-effective.
Conclusions:
- Linking emergency department patients without a medical provider to primary care providers via phone is as effective as face-to-face interaction.
- Phone-based PCP assignment strategies offer a time-efficient alternative for improving healthcare access for vulnerable pediatric populations.
Objective:
To compare the patient compliances and time analyses of two methods of assigning primary care providers (PCPs) to ED patients who are without a PCP: phone interview vs face-to-face interaction.
Methods:
Prospective observational cohort study following an intervention, performed in a pediatric ED, serving a population of 1.7 million, with a census of 80,000 pediatric ED visits per year. Over one year, a consecutive sampling of 1,062 patients evaluated in the ED and without a PCP were approached to participate in our study (536 enrolled, 526 declined). Patients enrolled were addressed by a nurse practitioner/social worker (NP/SW) who arranged an appointment with a PCP, either in person (in ED) or by phone after discharge. The primary outcome measure was compliance with the arranged appointment. Secondarily, the authors analyzed the time necessary for each approach in person-hours.
Results:
Of the 536 enrolled, 81 were excluded because data collection was incomplete at the time of the study's completion, leaving 455 study patients. Seventy-six percent of the study patients were between the ages of 1 month and 12 years. Contact was made by phone for 151 (33%) patients and face-to-face for 304 (67%). Sixty-two percent of the phone patients kept their appointments, compared with 52% of face-to-face patients (p = 0.048, RR = 1.20, 1.02 < RR < 1.41). Phone interaction was also more time effective.
Conclusion:
Linking ED patients without a medical provider to PCPs via phone is as effective as a face-to-face interaction.
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