Referral of medically uninsured emergency department patients to primary care

Melissa Lee McCarthy, Jon Mark Hirshon, Rebecca L. Ruggles, Anne Boland Docimo, Melvin Welinsky, Edward Bessman

Research output: Contribution to journalArticle

Abstract

Objective: To examine the impact primary care referral has on subsequent emergency department (ED) utilization. Methods: Uninsured ED patients who reported not having a primary care (PC) provider were referred to PC services at a community health center (CHC). The number of CHC visits completed was documented and the utilization rates of hospital-based services (i.e., ED visits, outpatient clinic visits, and admissions) were compared for patients who completed a CHC visit and those who did not before and after referral. Results: Of the 655 referred patients, 22% completed at least one CHC visit. Patients who completed a visit were more likely to be older, to be female, and to have a chronic medical problem (p = 0.001). The number of visits to the CHC was significantly related to the payment method. Only 19% of those who were self-pay completed three or more CHC visits, compared with 63% of those who qualified for a sliding fee or insurance (p <0.001). There was no significant difference in pre- or post-ED utilization between those who completed a CHC visit and those who did not. The only significant difference in utilization between the two study groups was for subsequent outpatient visits. Patients who completed a CHC visit were more likely to receive outpatient specialty care (23%) compared with patients who did not (12%) (p = 0.001). Conclusions: For uninsured patients with no regular health care provider, improving access to primary care services is not enough to reduce their visits to the ED.

Original languageEnglish (US)
Pages (from-to)639-642
Number of pages4
JournalAcademic Emergency Medicine
Volume9
Issue number6
DOIs
StatePublished - 2002

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Community Health Centers
Hospital Emergency Service
Primary Health Care
Referral and Consultation
Ambulatory Care
Fees and Charges
Ambulatory Care Facilities
Insurance
Health Personnel
Outpatients

Keywords

  • Access
  • Emergency department
  • Primary care
  • Referral
  • Utilization

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

McCarthy, M. L., Hirshon, J. M., Ruggles, R. L., Boland Docimo, A., Welinsky, M., & Bessman, E. (2002). Referral of medically uninsured emergency department patients to primary care. Academic Emergency Medicine, 9(6), 639-642. https://doi.org/10.1197/aemj.9.6.639

Referral of medically uninsured emergency department patients to primary care. / McCarthy, Melissa Lee; Hirshon, Jon Mark; Ruggles, Rebecca L.; Boland Docimo, Anne; Welinsky, Melvin; Bessman, Edward.

In: Academic Emergency Medicine, Vol. 9, No. 6, 2002, p. 639-642.

Research output: Contribution to journalArticle

McCarthy, ML, Hirshon, JM, Ruggles, RL, Boland Docimo, A, Welinsky, M & Bessman, E 2002, 'Referral of medically uninsured emergency department patients to primary care', Academic Emergency Medicine, vol. 9, no. 6, pp. 639-642. https://doi.org/10.1197/aemj.9.6.639
McCarthy, Melissa Lee ; Hirshon, Jon Mark ; Ruggles, Rebecca L. ; Boland Docimo, Anne ; Welinsky, Melvin ; Bessman, Edward. / Referral of medically uninsured emergency department patients to primary care. In: Academic Emergency Medicine. 2002 ; Vol. 9, No. 6. pp. 639-642.
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