Reconnecting patients with their primary care provider: an intervention for reducing nonurgent pediatric emergency department visits

Jesse J Sturm; Daniel Hirsh; Brad Weselman; Harold K Simon

doi:10.1177/0009922814540987

Reconnecting patients with their primary care provider: an intervention for reducing nonurgent pediatric emergency department visits

Clin Pediatr (Phila). 2014 Sep;53(10):988-94. doi: 10.1177/0009922814540987. Epub 2014 Jul 8.

Authors

Jesse J Sturm¹, Daniel Hirsh², Brad Weselman³, Harold K Simon²

Affiliations

¹ Connecticut Children's Medical Center, West Hartford, CT, USA University of Connecticut School of Medicine, Farmington, CT, USA jesse.sturm@gmail.com.
² Children's Healthcare of Atlanta, Atlanta, GA, USA Emory University School of Medicine, Atlanta, GA, USA.
³ Kids Health First Primary Care Network, Atlanta, GA, USA.

PMID: 25006110
DOI: 10.1177/0009922814540987

Abstract

Objective: Intervention to reduce nonurgent pediatric emergency department (PED) visits over a 12-month follow-up.

Methods: Prospective, randomized, controlled trial enrolled children seen in the PED for nonurgent concerns. Intervention subjects received a structured session/handout specific to their primary care provider (PCP), which outlined ways to obtain medical advice. Visitation to the PED and PCP were followed over 12 months.

Results: A total of 164 patients were assigned to the intervention and 168 patients to the control. At 12-month follow-up, the intervention group had a lower rate of nonurgent PED utilization compared with the control group (70 [43%] patients in the intervention compared with 91 [54%] in the control; P = .047). At 12 months, there was an increase in the rate of sick visits to PCP in the intervention group when compared with the control (P = .036).

Conclusions: Intervention designed in cooperation with pediatricians was able to decrease nonurgent PED utilization and redirect patients to their PCP for future sick visits over a 12-month period.

Keywords: emergency department use; health care utilization.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
Child, Preschool
Counseling*
Emergency Service, Hospital / statistics & numerical data*
Female
Follow-Up Studies
Health Services Misuse*
Hospitals, Pediatric / statistics & numerical data
Humans
Infant
Male
Office Visits*
Parents / education
Patient Acceptance of Health Care*
Patient Education as Topic*
Primary Health Care / statistics & numerical data*
Prospective Studies
Referral and Consultation / statistics & numerical data
Risk Factors
Tertiary Care Centers / statistics & numerical data
United States