Enhanced emergency department referral improves primary care access.
OBJECTIVE
People who use the emergency department (ED) as their main source of medical care cite access barriers to primary care as the reason. The purpose of this study was to test an intervention designed to refer regular ED users to primary care.


METHODS
A prospective randomized clinical trial.


METHODS
Adults who stated the ED is their regular source of care and have no primary care (n = 189) were randomized to 2 groups: the intervention being studied or usual care. The study took place over 3 months at a northeastern urban hospital.


RESULTS
Subjects in the intervention group were more than twice as likely to keep the primary care appointment compared with the usual care group, and most also received some measure of preventive care. There was no significant difference in ED utilization by these patients in the 12-month period following study entry.


CONCLUSIONS
Making an appointment with detailed instructions during a visit to the ED markedly improves show rates at follow-up appointments with a primary care provider and allowed for opportunity to provide important preventive services.
O'Brien
G M
GM
Division of General Internal Medicine, Rhode Island Hospital, Providence 02903, USA. GObrien@Lifespan.org
Stein
M D
MD
Fagan
M J
MJ
Shapiro
M J
MJ
Nasta
A
A
D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England; D010349:Patient Compliance; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011897:Random Allocation; D012017:Referral and Consultation