Comprehensive pediatric primary care vs traditional care in an Israeli population: their influence on pediatric emergency room use and hospitalization.

Abstract

Emergency room (ER) utilization and hospitalization were studied as indicators of the impact of improvements in pediatric primary care services in an Israeli development town, Ofakim, population 12,000. One of the two pediatric services was upgraded in 1976 through the introduction of pediatric faculty, integration of preventive and curative services and conversion of the medical records to a problem-oriented format ("experimental" clinic "B"). The primary care system remained unchanged in the second clinic ("traditional" clinic "A"). During 1980, ER utilization by the "B" clinic population was 9.3/100 compared with 17.6/100 for the "A" clinic population. Fifty two percent of the "B" clinic population patients reaching the ER were hospitalized compared with 25% of "A" clinic patients. The lower ER utilization rate represents a significant saving for the health services, and educational interventions are suggested from the study. Analysis of ER utilization data seems to offer useful information for overall planning and monitoring of ambulatory services for a community.