title: Linking emergency department patients to primary care: phone vs face-to-face interaction.
abstract: OBJECTIVE
  To compare the patient compliances and time analyses of two methods of assigning primary care providers (PCPs) to ED patients who are without a PCP: phone interview vs face-to-face interaction.
  
  
  METHODS
  Prospective observational cohort study following an intervention, performed in a pediatric ED, serving a population of 1.7 million, with a census of 80,000 pediatric ED visits per year. Over one year, a consecutive sampling of 1,062 patients evaluated in the ED and without a PCP were approached to participate in our study (536 enrolled, 526 declined). Patients enrolled were addressed by a nurse practitioner/social worker (NP/SW) who arranged an appointment with a PCP, either in person (in ED) or by phone after discharge. The primary outcome measure was compliance with the arranged appointment. Secondarily, the authors analyzed the time necessary for each approach in person-hours.
  
  
  RESULTS
  Of the 536 enrolled, 81 were excluded because data collection was incomplete at the time of the study's completion, leaving 455 study patients. Seventy-six percent of the study patients were between the ages of 1 month and 12 years. Contact was made by phone for 151 (33%) patients and face-to-face for 304 (67%). Sixty-two percent of the phone patients kept their appointments, compared with 52% of face-to-face patients (p = 0.048, RR = 1.20, 1.02 < RR < 1.41). Phone interaction was also more time effective.
  
  
  CONCLUSIONS
  Linking ED patients without a medical provider to PCPs via phone is as effective as a face-to-face interaction.
authors.affiliation: Department of Pediatrics, Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati, OH, USA. jmkallis@aol.com
authors.forename: J M
authors.initials: JM
authors.lastname: Kallis
authors.forename: J A
authors.initials: JA
authors.lastname: Gonzalez del Rey
authors.forename: R M
authors.initials: RM
authors.lastname: Ruddy
authors.forename: C J
authors.initials: CJ
authors.lastname: Schubert
mesh_terms: D000359:Aftercare / Q000458:organization & administration*; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D009722:Nurse Practitioners / Q000458:organization & administration; D009820:Ohio; D010349:Patient Compliance / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D011446:Prospective Studies; D012947:Social Work / Q000458:organization & administration; D013689:Telephone; D013997:Time Factors