Emergency Department Referral Process and Subsequent Use of Safety-Net Clinics

We analyzed data on 10,761 low-income emergency department (ED) patients participating in the Emergency Department-Primary Care Connect program to identify successful methods of disseminating information on availability of primary care clinics. Data were obtained from all five hospitals in Montgomery County, Maryland, four participating county clinics, and from patient navigators. A two-part negative binomial model estimated factors associated with the probability of a clinic visit following a referral, and factors associated with the frequency of subsequent clinic visits. Twenty-one percent of patients had a subsequent clinic visit, and two-thirds of these patients returned for a second clinic visit. Patients were more likely to make the initial clinic visit if the referral was made by both the ED Provider and the patient navigator, relative to referral by the ED provider only. ED providers and patient navigators helped patients gain access to primary care services by referring them to safety-net clinics.