Reducing Repeat Emergency Department Visits for Low-Acuity Patients Using a Healthcare Connection Program

Area of Science:

• Health Services Research
• Public Health
• Healthcare Management

Background:

• High emergency department (ED) utilization for non-emergent issues is a persistent problem, particularly in areas with high Medicaid enrollment.
• The Medical Home and Specialty Care Connection Program (MHSCC) at University of Chicago Medicine (UCM) aims to reduce this by connecting patients with primary care and providing education.
• Existing research on similar programs shows inconsistent results and limited study periods.

Purpose of the Study:

• To evaluate the effectiveness of the MHSCC program in reducing low-acuity ED utilization among its patients.
• To assess the program's impact on healthcare-seeking behaviors and primary care engagement.

Main Methods:

• Retrospective analysis of MHSCC program data (2012-2020) and UCM ED electronic health records (2010-2022).
• Comparison of pre- and post-enrollment low-acuity ED visit rates using the Wilcoxon signed-rank test.
• Inclusion of 5,482 patients with 41,530 low-acuity ED visits.

Main Results:

• A significant 45% decrease in low-acuity ED visits was observed, from a mean of 2.5 visits/year pre-intervention to 1.38 visits/year post-intervention (P<.0001).
• An estimated 9,487 fewer low-acuity ED visits occurred over nine years due to the program.
• Patients with multiple program enrollments showed slightly lower ED visit rates, with low-acuity patients benefiting the most.

Conclusions:

• The MHSCC program effectively reduced ED visit rates for low-acuity needs among its patient population.
• Further research is recommended to explore program outcomes, physician referral mechanisms, and patient population characteristics driving these results.