Nonemergent Emergency Department Use Among Patients With a Usual Source of Care

Villani, Jennifer; Mortensen, Karoline

doi:10.3122/jabfm.2013.06.120327

Cited by 34 publications

(18 citation statements)

References 32 publications

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“…While we document that having a Person USC, rather than a place had positive effects on utilization, the impact was more consistent among low‐income individuals and with respect to ED visits. Although our methods do not allow us to disentangle how providers and facilities interact to enable access, others have found that patient–provider language concordance, after‐hours access, and longitudinal relationships are USC characteristics associated with reduced ED use (O'Malley ; Villani and Mortensen ; Haber, Wensky, and McCall ). We predict the types of USCs offered and their respective competencies will continue to evolve in response to policy changes.…”

Section: Discussionmentioning

confidence: 99%

“…Having a singular person or facility for navigating most health care needs, also known as a usual source of care (USC), can facilitate access to the right care (DeVoe et al. ) at the right place (Villani and Mortensen ; Liaw et al. ; Janke et al.…”

mentioning

confidence: 99%

“…When patients have a trusted guide, they change their care‐seeking behavior, which has positive effects on the health care system. For example, studies have found that those with a USC rely less on emergency departments (EDs; Villani and Mortensen ; Liaw et al. ; Janke et al.…”

mentioning

confidence: 99%

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Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All

Liaw

Jetty

Petterson

et al. 2017

Health Services Research

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All

Liaw

Jetty

Petterson

et al. 2017

Health Services Research

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“…Previous studies in Catalonia found that parents with a low educational level were more likely to use emergency medical services, as were parents of children with additional, private health coverage 16 . The potentially inappropriate use of emer-gency services was linked to the level of knowledge of the health services available and working hours 36 , in particular among immigrants with precarious work conditions 37 , A study using data from the 2007-2009 Medical Expenditure Panel Survey in US, showed how one element of communication like patient-provider language concordance, was associated with fewer nonemergent visits to emergency department 38 .…”

Section: Discussionmentioning

confidence: 99%

Experiências com a atenção primária associadas à saúde, características sociodemográficas e uso de serviços em crianças e adolescentes

et al. 2014

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Este estudo avaliou as experiências com a atenção primária à saúde para crianças e adolescentes, considerando níveis de saúde, características sociodemográficas e o uso de serviços de saúde. A Enquete de Saúde de Catalunha de 2006 incluiu uma amostra representativa da população de 0 a 14 anos (n = 2.200). Pessoas adultas informaram suas experiências com a atenção primária à saúde de seus filhos com uma seleção de 17 itens do Primary Care Assessment Tool. Estimaram-se razões de prevalência (RP) de baixa pontuação em seis funções da atenção primária à saúde mediante modelos multivariados. A declaração de doenças crônicas se associou à baixa pontuação no primeiro contato-acessibilidade. Os pais imigrantes declararam pior experiência com várias funções da atenção primária à saúde. As pontuações no primeiro contato-acessibilidade, continuidade da atenção e competência cultural foram mais altas quando as crianças tinham cobertura sanitária dupla e mais baixas quando tinham visitado os serviços de emergência. Melhorias em algumas funções da atenção primária à saúde poderiam reduzir o uso de serviços de urgência e iniquidade.

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“…8 Neither of these should be unexpected, but continue to reinforce the importance of physician-patient communication in the office and the short geographic distances to primary care.…”

Section: Office Provision Of Health Servicesmentioning

confidence: 99%

Family Physicians Improve Patient Health Care Quality and Outcomes

Bowman¹,

Neale²

2013

The Journal of the American Board of Family Medicine

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This issue exemplifies family physicians' ability to provide great care and to continuously improve. For example, beyond other specialty care, the care provided by family physicians is associated with improved melanoma diagnosis and outcomes and improved preventive services for those with a history of breast cancer. Electronic health records are providing new avenues to both assess outcomes and influence care. However, to truly reward quality care, simplistic and readily measurable items such as laboratory results or assessment of the provision of preventive services must be adjusted for risk. Health insurance influences classic preventive care services more than personal health behaviors. The care provided at federally qualified health centers throughout the nation is highly appreciated by the people they serve and is not plagued by the types of disparities in other settings. (J Am Board Fam Med 2013; 26:617-619.)Maly et al 1 show the positive impact of family physicians on recommended preventive services in the follow-up care of underserved female breast cancer survivors. The disparity between specialities was dramatic for colonoscopy in particular, where only a quarter of patients seeing only surgeons/ cancer specialists for follow-up received the recommended screening.Related to another cancer-melanoma-Roetzheim et al 2 showed that visiting a family physician compared with only a dermatologist before the diagnosis of melanoma was associated with a diagnosis of more thin melanomas and possibly a lower rate of mortality. To improve the accuracy of detection of skin cancers, Eide et al 3 tested an intriguing intervention using a readily available, 1-to 2-hour, interactive web-based course. In addition to evaluations after the course, this study considered referrals to dermatology before and after the course and diagnoses after the course. Most of the providers had trained in internal medicine. The evaluations immediately and after 6 months found improved scores, and the later practice patterns found fewer referrals to dermatology but no obvious change in the rate of diagnosis of skin cancers. The physicians reporting no past dermatology training had the greatest improvement. Effects of Insurance on Preventive Services and Health BehaviorsJerant et al 4 reported that patients who newly obtained health insurance after being uninsured clearly receive more recommended preventive care that are based on the health system (eg, Papanicolaou tests, mammograms, and immunizations); the opposite is also true: losing insurance decreases these services. Yet patients' personal health behaviors did not improve or worsen with changes in health insurance. Unfortunately, this questions the ability of the health care system to either recognize negative patient behaviors, assist patients in changing them, or both. Perhaps follow-up longer than 1 year would change these outcomes since behavior changes often take repeated efforts over multiple years.

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Nonemergent Emergency Department Use Among Patients With a Usual Source of Care

Cited by 34 publications

References 32 publications

Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All

Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All

Experiências com a atenção primária associadas à saúde, características sociodemográficas e uso de serviços em crianças e adolescentes

Family Physicians Improve Patient Health Care Quality and Outcomes

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