Web-based primary care referral program associated with reduced emergency department utilization.
OBJECTIVE
Uninsured patients without a primary care home tend to use the emergency department (ED) for primary care. We examined whether an enhanced scheduling system for follow-up care from the University of New Mexico Hospital Emergency Department (UNMH-ED) that assigns patients to a family medicine home can decrease ED utilization.


METHODS
The Community Access Program for Central New Mexico (CAP-NM) is a consortium of primary care safety net provider organizations. CAP-NM developed a HIPAA-compliant (Health Insurance Portability and Accountability Act), Web-based information system used by the UNMH-ED to refer uninsured, unassigned patients to family medicine practices ("homes") within the consortium. The Web site referral system operated 24 hours a day, 7 days a week; printed maps to clinic sites; and listed services offered. Analysis of quality assurance data compared (1) ED utilization outcomes of eligible patients referred by the CAP-NM Web site to a family medicine home to (2) outcomes of controls discharged from the ED in the usual manner.


RESULTS
The 756 patients referred to family medicine homes through the CAP-NM Web site demonstrated a significant 31% reduction in subsequent ED visits compared to controls. This reduction was most evident among those who had infrequent ED use before institution of the program.


CONCLUSIONS
Implementing an enhanced referral system to family medicine homes from the ED is associated with decreased subsequent ED utilization by uninsured patients.
Murnik
Michael
M
Department of Family and Community Medicine, University of New Mexico, Albuquerque 87131-0001, USA. mmurnik@salud.unm.edu
Randal
Fornessa
F
Guevara
Mary
M
Skipper
Betty
B
Kaufman
Arthur
A
D001071:Appointments and Schedules; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005194:Family Practice / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D017057:Medically Uninsured; D009516:New Mexico; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data