Utilization of emergency services among patients of a pediatric group practice.

Abstract

Pediatric group practices in university hospitals provide primary care to children who are often from indigent families. Those practices that attempt to provide care in a continuous way often encounter difficulty in attempting to change their patients' patterns of emergency department utilization. This study attempts to define the relationship between patient characteristics such as access to a telephone and inappropriate utilization of the emergency department. A university hospital database was reviewed to identify all patients of the pediatric group practice. Emergency department records over a six-month period were reviewed to identify all visits of group practice patients to the emergency department. Patients without access to a telephone were more likely to inappropriately access care in the emergency department than were patients with phone access. However, within the cohort of emergency department utilizers, phone access was not a predictor of use. Of those who used the emergency department, babies and young children and those of indigent status were more likely to inappropriately access care than were older children and those at a higher socioeconomic level. We conclude that the demographic information of clients in a pediatric group practice can be utilized to predict inappropriate utilization of emergency department services and that this information can be used to implement programs to help foster continuity of care.