Abstract
BackgroundThe aim of this study was to evaluate the association between different primary paediatric practice models (individual, network -affiliated but in separate office-, and group practice) and non urgent utilization of the Emergency Department (ED).MethodsThe data sources were: the 2006 Regional Paediatric Patient files (0-6 years old), the Regional Community-based paediatrician (CBP) file and the 2006 Emergency Information System. We recorded and studied the ED visits of children, excluding planned ED visits, visits for trauma/poisoning and those that were assigned non deferrable/critical triage codes. A multivariate logistic regression was applied to estimate the adjusted odds ratio of an ED visit. The exposure was the type of paediatric practice that served the child: individual, network or group practice. Various characteristics of the child were considered.ResultsThe cohort was composed of 293,662 children. In the 2006, 43,347 ED visits occurred (147.6 per 1000). Multivariate logistic models showed lower ED use for group paediatrician patients (OR 0.84; 95%CI 0.73-0.96) and for network paediatrician patients (OR 0.92; 95%CI 0.85-1.00) compared to patients served by an individual practice.ConclusionsThis study shows that there is a weak association between the type of paediatrician primary practice and emergency department use. Our results highlight the necessity to continue to improve the organization of paediatrician primary practice, in order to increase patient access to primary paediatric care.
Highlights
IntroductionThe aim of this study was to evaluate the association between different primary paediatric practice models (individual, network -affiliated but in separate office-, and group practice) and non urgent utilization of the Emergency Department (ED)
The aim of this study was to evaluate the association between different primary paediatric practice models and non urgent utilization of the Emergency Department (ED)
In Italy, in order to improve the quality and continuity of care provided by Communitybased paediatrician (CBP) and in order to reduce inappropriate ED visits, in addition to the traditional primary care model, where each CBP works independently, Italian CBPs have the choice of participating in a network of other paediatric practices while working from their own office, or to work in a group paediatric practice, sharing offices and patient electronic health record systems with other paediatricians
Summary
The aim of this study was to evaluate the association between different primary paediatric practice models (individual, network -affiliated but in separate office-, and group practice) and non urgent utilization of the Emergency Department (ED). The aim of primary paediatric care is to promote children's health through diagnostic, therapeutic and preventive services [1,2,3,4,5]. In Italy, in order to improve the quality and continuity of care provided by CBPs and in order to reduce inappropriate ED visits, in addition to the traditional primary care model, where each CBP works independently, Italian CBPs have the choice of participating in a network of other paediatric practices while working from their own office, or to work in a group paediatric practice, sharing offices and patient electronic health record systems with other paediatricians. Network and group practice models are intended to maximize CBP
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