title: Ambulatory care sensitive emergency department use among low-cost medical home patients.
abstract: Rates of hospitalization for ambulatory care sensitive conditions (ACSC, non-emergent or primary-care-treatable) are indicators of access to and effectiveness of primary care. An assessment of Bridges to Care (BTC), a program that links Nashville's uninsured population to a medical home, was performed by surveying 76 of 756 patients presenting to the Vanderbilt emergency department (ED) between January and March 2007. Rates of ACSCs among BTC patients were not different than those of the uninsured/non-BTC or insured. A 20-item telephone survey showed that reasons for using EDs for ACSCs were not different between BTC and non-BTC patients. More BTC than non-BTC patients cited cost of healthcare as a problem that needed to be improved (p = 0.04). BTC patients have similar ACSC rates when compared to both uninsured/non-BTC and insured patients, and it is likely that cost remains a factor in their accessing healthcare services.
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. maria.e.carlo@vanderbilt.edu
authors.forename: Maria E
authors.initials: ME
authors.lastname: Carlo
authors.forename: James S
authors.initials: JS
authors.lastname: Powers
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D008483:Medical Assistance / Q000458:organization & administration*; D017057:Medically Uninsured; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration*; D013714:Tennessee