Primary care access barriers as reported by nonurgent emergency department users: implications for the US primary care infrastructure.
The objective was to explore variation by insurance status in patient-reported barriers to accessing primary care. The authors fielded a brief, anonymous, voluntary survey of nonurgent emergency department (ED) visits at a large academic medical center and conducted descriptive analysis and thematic coding of 349 open-ended survey responses. The privately insured predominantly reported primary care infrastructure barriers-wait time in clinic and for an appointment, constraints related to conventional business hours, and difficulty finding a primary care provider (because of geography or lack of new patient openings). Half of those insured by Medicaid and/or Medicare also reported these infrastructure barriers. In contrast, the uninsured predominantly reported insurance, income, and transportation barriers. Given that insured nonurgent ED users frequently report infrastructure barriers, these should be the focus of patient-level interventions to reduce nonurgent ED use and of health system-level policies to enhance the capacity of the US primary care infrastructure.
The Ohio State University, Columbus, OH Jennifer.Hefner@osumc.edu.
Jennifer L
JL
Hefner
The Ohio State University, Columbus, OH.
Randy
R
Wexler
The Ohio State University, Columbus, OH.
Ann Scheck
AS
McAlearney
D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006297:Health Services Accessibility; D006300:Health Services Misuse; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D014481:United States; D055815:Young Adult
access to care; emergency department; health policy; primary care