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Association between infant continuity of care and pediatric emergency department utilization

David C Brousseau1, John R Meurer, Mayme L Isenberg

  • 1Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. dbrousse@mail.mcw.edu

Pediatrics
|April 3, 2004
PubMed

Insights

Continuity of care in infancy is linked to fewer emergency department visits. Promoting consistent well-child visits can reduce healthcare utilization in infants.

Area of Science:

  • Pediatrics
  • Health Services Research
  • Preventive Medicine

Background:

  • Infancy is a critical period for establishing healthcare relationships.
  • High healthcare utilization, including emergency department (ED) visits, is common during infancy.
  • Continuity of care (COC) may influence health outcomes and service use.

Purpose of the Study:

  • To investigate the association between continuity of care (COC) during infancy and subsequent emergency department (ED) utilization.
  • To understand how early healthcare relationships impact ED reliance and visit frequency.

Main Methods:

  • Retrospective birth cohort study of 181 infants (born Dec 1999-Apr 2000).
  • Continuity of care (COC) score calculated from early well-child visits (first 7 months).
  • Emergency department (ED) utilization measured by ED reliance and number of ED visits at 12 and 18 months, analyzed using Spearman rank correlation.

Main Results:

  • Continuity of care (COC) was negatively correlated with both ED reliance and the number of ED visits at 12 months (r(s) = -.214 and r(s) = -.215, respectively).
  • This negative association strengthened at 18 months (ED reliance: r(s) = -.247; number of ED visits: r(s) = -.242).
  • The relationship remained statistically significant after controlling for Medicaid status, income, gender, and total healthcare visits.

Conclusions:

  • Improved continuity of care (COC) in infancy is associated with reduced emergency department (ED) utilization.
  • Interventions focused on enhancing continuity of early well-child care may be effective in decreasing infant ED visits.
Abstract

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