title: Community Primary Care Provider Preferences for Emergency Department Follow-up Recommendations: A Regional Study.
abstract: BACKGROUND
  Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients.
  
  
  OBJECTIVE
  The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice.
  
  
  METHODS
  This was an online survey of PCPs and EMPs in a regional health system assessing preferred timing for ED follow-up recommendations for 15 common pediatric conditions and whether the follow-up should be definite or contingent.
  
  
  RESULTS
  Ninety PCPs and 36 EMPs responded to the survey. In patients with community-acquired pneumonia, probability of recommending follow-up after 5 or more days was 33% in PCPs and 8% in EMPs (P = 0.001). In all conditions with significant differences, PCPs favored longer follow-up. In upper respiratory tract infection and acute otitis media, PCPs had a higher probability than EMPs of selecting as-needed versus definite follow-up (P = 0.0002 and P = 0.01, respectively). In asthma, concussion, and pneumonia, PCPs had a significantly lower probability of selecting as-needed follow-up than EMPs.
  
  
  CONCLUSIONS
  In this regional survey, PCPs preferred longer times between ED visit and follow-up than EMPs for a number of conditions. Differences were also found in preference for as-needed or definite follow-up, varying by condition. These discrepancies could result in overuse or underuse of clinic resources, suggesting a possible quality improvement target for emergency medicine practice.
authors.affiliation: From the *Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota Medical School and University of Minnesota Masonic Children's Hospital; and †Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN; ‡Biostatistics and Data Management Core, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI; and §Department of Mathematics and Statistics, Auburn University, Auburn, AA.
authors.forename: Marissa A
authors.initials: MA
authors.lastname: Hendrickson
authors.forename: Eta
authors.initials: E
authors.lastname: Obeya
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Wey
authors.forename: Philippe R
authors.initials: PR
authors.lastname: Gaillard
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003153:Community Health Services; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult