The Relationship between Same-Day Access and Continuity in Primary Care and Emergency Department Visits

PLoS One. 2015 Sep 2;10(9):e0135274. doi: 10.1371/journal.pone.0135274. eCollection 2015.

Abstract

We examined how emergency department (ED) visits for potentially preventable, mental health, and other diagnoses were related to same-day access and provider continuity in primary care using administrative data from 71,296 patients in 22 VHA clinics over a three-year period. ED visits were categorized as non-emergent; primary care treatable; preventable; not preventable; or mental health-related. We conducted multi-level regression models adjusted for patient and clinic factors. More same-day access significantly predicted fewer non-emergent and primary care treatable ED visits while continuity was not significantly related to any type of ED visit. Neither measure was related to ED visits for mental health problems.

MeSH terms

  • California
  • Cohort Studies
  • Emergency Service, Hospital* / organization & administration
  • Emergency Treatment
  • Health Care Surveys
  • Health Services Accessibility* / organization & administration
  • Humans
  • Multivariate Analysis
  • Primary Health Care* / organization & administration
  • Regression Analysis

Grants and funding

Dr. Rubenstein is employed by the RAND Corp. The funder of our work (VA) provided support in the form of salaries for authors JY, KMC, AC, and LVR, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.