Abstract
Objective
We aim to evaluate the effectiveness of a broadly inclusive, comparatively low intensity
intervention linking ED patients to a primary care home.
Methods
This retrospective cohort study evaluated ED patients referred for primary care linkage
in a large, urban, academic ED. A care coordination specialist performed a brief interview
to gauge access barriers and provide a clinic referral with optional scheduling assistance.
Data were abstracted from program records and the electronic medical record. The primary
outcome was the proportion of referred individuals who attended at least one primary
care appointment.
Secondary outcomes included return ED encounters within one year, and factors associated
with linkage outcomes.
Results
There were 2142 referrals made for 2064 patients; 1688/2142 accepted assistance. Linkage
was successful for 1059/1688 (63%, CI95 60% to 65%). Among patients accepting assistance,
those without successful linkage were younger (41 vs 45 years, difference 3 years, CI95 2 to 3), more often male (62% vs 55%,difference 7%, CI95 2% to 12%), and
less likely to have a chronic medical condition (37% vs 45%, difference 8%; CI95 3%
to 12%) or to have had an appointment scheduled within two weeks (26% vs 33%, difference
7%, CI95 2% to 12%). Insurance status and self-reported barriers to care were not
associated with linkage success. Patterns of subsequent ED use were similar, regardless
of referral status or linkage outcome.
Conclusion
Low intensity, broadly inclusive, ED care coordination linked nearly 50% of patients
referred for intervention, and two-thirds of willing participants, with a primary
care home.
Keywords
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Article Info
Publication History
Published online: April 05, 2018
Accepted:
April 3,
2018
Received in revised form:
April 2,
2018
Received:
October 17,
2017
Footnotes
â?†Prior Presentations: Presented at the Society for Academic Emergency Medicine Annual Meeting, Dallas, May, 2014.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
