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Why Parents Use the Emergency Department Despite Having a Medical Home
Kalpana Pethe1,2, Allison Baxterbeck2, Susan L Rosenthal1,3
11 Department of Pediatrics, Columbia University Medical Center-Vagelos College of Physicians and Surgeons, New York, NY, USA.
Insights
Parents often use emergency departments (EDs) for pediatric care, even with a medical home. Enhancing communication about clinic access is crucial for reducing unnecessary ED visits in underserved communities.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Public Health
Background:
- Pediatric patients frequently utilize emergency departments (EDs) despite having a medical home.
- Understanding parental decision-making for ED care is essential for improving healthcare access.
Purpose of the Study:
- To examine parental reasons for seeking emergency department (ED) care among low-income, inner-city, publicly insured children.
- To identify factors influencing ED utilization within a medical home model with enhanced access.
Main Methods:
- Surveys were conducted with parents of children (age 0-19) presenting to a community-based clinic.
- The study focused on children with established medical homes and enhanced access services.
Main Results:
- Most surveyed children (88.3%) had a pediatrician, and nearly all (93.3%) had visited an ED.
- While many parents knew about clinic walk-in hours (75.7%), fewer knew about after-hours phone lines (42.6%).
- Parental awareness of clinic access hours did not significantly correlate with ED visit frequency.
Conclusions:
- Medical homes need to actively promote awareness of enhanced access services, including after-hours care.
- Improving communication about available resources can potentially decrease non-urgent emergency department utilization.
Abstract:
Despite having a medical home, pediatric patients continue emergency department (ED) utilization for various reasons. This study examines parental reasons associated with the decision to seek ED care in a group of low-income, inner-city, publicly insured children. Surveys were conducted with parents of children (age = 0-19 years) presenting to a community-based clinic, which has an established medical home model with enhanced access. Most patients (88.3%) had a pediatrician, and nearly all (93.3%) reported a visit to the ED; most (75.7%) were aware of clinic walk-in hours, but less than half (42.6%) were aware of an after-hours phone line. There was no difference in those who were aware of walk-in hours or an after-hours phone line and a reported ED visit. Half of the parents (52.5%) thought their child's medical problem was serious. In addition to providing enhanced efforts, medical homes should strive to make families aware of increased access.
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