Primary Care Organization and Outcomes of an Emergency Visit among Seniors

This study explored whether organizational characteristics of primary care services provided by area of residence in two Quebec regions are related to outcomes of an emergency department (ED) visit among seniors discharged home. Provincial administrative databases on a sample of seniors who made an ED visit and their 30-day outcomes were linked by area of residence to data from a survey of key informants from primary care clinics. Measures of organizational characteristics included three scales derived from principal components analysis and one theoretically derived global score that measured the degree of conformity to characteristics of ideal emerging primary care models. In multivariate analyses, adjusting for patient characteristics, patients living in areas in the lowest quartile for the global score had higher rates of return ED visits without hospitalization. Emerging primary care organizational models along the lines currently being pursued in Quebec may help to reduce the growing burden of ED care of seniors.