No brainer

Better access to primary care can reduce the use of emergency rooms by Medicaid patients, according to a study from Oregon Health and Science University published in Medical Care. Key findings:

  • Patients whose PCPs have evening and weekend hours use the ER less
  • Patients used the ER more when their PCP practice had lots of Medicaid patients and when their practice had nurse practitioners and physician assistants. (I only have access to the abstract –and I’m curious about what’s behind this one. Although physicians on this blog have indicated that they like nurse practitioners, in my own experience I’ve gotten bad advice from nurse practitioners that’s made things worse.)
  • Practices with nebulizers for bronchodilators and peak flow meters had lower ER use

There are other ways to improve access to primary care and reduce ER use besides convenient hours and a broad scope of services. Better communication –whether by timely and well structured electronic messaging or phone– can prevent little problems from becoming big ones.

November 7, 2005

One thought on “No brainer”

  1. In the November 2005 number of Pediatrics a similar study from Broward County, Florida showed much more disappointing results.

    The group randomized to the open-access clinic used the ED only 8% less than the control group, and the cost per month per patient was identical in both groups.

    The problem remains that the barriers to inappropriate use of ED services are too low.

    As long as the ED is free to medicaid patients, why WOULDN’T this population use them?

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