Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences...

Area of Science:

• Health Services Research
• Primary Care Medicine
• Public Health Policy

Background:

• Global health systems face increasing pressure on expensive hospital services.
• Primary care's potential to manage demand and reduce hospital costs is recognized.
• Current primary care services lack evening and weekend availability, impacting accessibility.

Purpose of the Study:

• To evaluate the impact of extended primary care access on emergency department (ED) visits.
• To assess the effect of evening and weekend primary care opening on hospital service utilization.
• To provide evidence for improving primary care delivery and reducing healthcare costs.

Main Methods:

• A difference-in-differences analysis was conducted using hospital administrative data from 2011-2014.
• Propensity score matching was employed to compare practices with and without extended access.
• The study focused on "minor" patient-initiated emergency department visits and associated costs.

Main Results:

• Extended primary care access was associated with a 26.4% relative reduction in "minor" ED visits.
• A 26.6% relative reduction in costs for these ED visits was observed.
• Total ED visits showed an insignificant reduction of 3.1%.

Conclusions:

• Extended primary care access demonstrated a significant reduction in emergency department visits for minor problems.
• The findings have influenced NHS England's decision to expand primary care access.
• Further research is required to ascertain the cost-effectiveness and sustainability of extended access models.