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Clin Pediatr (Phila). 2019 Jan;58(1):95-99. doi: 10.1177/0009922818809447. Epub 2018 Oct 26.

Why Parents Use the Emergency Department Despite Having a Medical Home.

Author information

1
1 Department of Pediatrics, Columbia University Medical Center-Vagelos College of Physicians and Surgeons, New York, NY, USA.
2
2 NewYork-Presbyterian Hospital, New York, NY, USA.
3
3 Department of Psychiatry,Columbia University Medical Center-Vagelos College of Physicians and Surgeons, New York, NY, USA.
4
4 Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA.

Abstract

Despite having a medical home, pediatric patients continue emergency department (ED) utilization for various reasons. This study examines parental reasons associated with the decision to seek ED care in a group of low-income, inner-city, publicly insured children. Surveys were conducted with parents of children (age = 0-19 years) presenting to a community-based clinic, which has an established medical home model with enhanced access. Most patients (88.3%) had a pediatrician, and nearly all (93.3%) reported a visit to the ED; most (75.7%) were aware of clinic walk-in hours, but less than half (42.6%) were aware of an after-hours phone line. There was no difference in those who were aware of walk-in hours or an after-hours phone line and a reported ED visit. Half of the parents (52.5%) thought their child's medical problem was serious. In addition to providing enhanced efforts, medical homes should strive to make families aware of increased access.

KEYWORDS:

access; chronic medical conditions; emergency department utilization; medical home; primary care physician

PMID:
30360654
DOI:
10.1177/0009922818809447

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