title: Is information sharing between the emergency department and primary care useful to the care of frequent emergency department users?
abstract: OBJECTIVE
  To assess whether easy access to medical information of the emergency department's (ED) frequent users would be useful to patient care in the ED and at primary healthcare centres (PHCs), and if resource utilization in the following year would be affected.
  
  
  METHODS
  During a 6-month period, frequent users presenting to the ED of Karolinska University Hospital Huddinge, Sweden, were randomized by the electronic database system into an intervention (n=834) or control group (n=965), the definition being three or more visits in 12 months before the index visit. Printout case notes, from the intervention patients' last three visits, were made accessible to the ED physicians and optionally forwarded to the patient's PHC physician. Usefulness of this enhanced information was measured by questionnaires, whereas healthcare utilization was compiled from the electronic database.
  
  
  RESULTS
  The case notes of 59 (7.1%) intervention patients were forwarded to the respective PHCs. Of these, access to the enhanced patient information was deemed useful in 82% cases in the ED, versus 76% in PHCs. The mean number of ED visits in the following year did not differ significantly in the total intervention group as compared with the controls: 4.0 and 3.9, respectively (P=0.49). Nor were there any differences in utilization of other care resources.
  
  
  CONCLUSIONS
  Although only a small subgroup's information was shared, yielding no decrease in overall healthcare utilization, the study indicated benefits of the enhanced information at the respective care level and also had important clinical and organizational implications.
authors.affiliation: Department of aClinical Neuroscience, Karolinska University Hospital, Huddinge, Sweden. helen.hansagi@sll.se
authors.forename: Helen
authors.initials: H
authors.lastname: Hansagi
authors.forename: Mariann
authors.initials: M
authors.lastname: Olsson
authors.forename: Aliasgher
authors.initials: A
authors.lastname: Hussain
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ohlén
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D010821:Physicians, Family; D011320:Primary Health Care; D019114:Remote Consultation; D013548:Sweden