"Though intervention patients trended toward having reduced postintervention ED visits, results were not statistically significant. In addition, the numbers of visits were small and of unclear clinical significance. Our intervention targeted all visitors, who mostly had low levels of ED use at baseline. Attempts to decrease nonurgent ED use, particularly among patients who are already infrequent users of EDs, are unlikely to significantly decrease ED crowding or costs.35, 36, 37, 38, 39, 40, 41 On the other hand, increased primary care linkage might result in improved care for chronic health conditions affecting millions of people, which could lead to long-term cost savings. As future health reforms begin financially rewarding hospitals for care coordination and quality of services rather than quantity, there will be increasing incentives for programs like ours that connect ED patients to a primary care home. In addition, as more Americans obtain health insurance, there will be a need to link these newly insured—who may initially seek ED care for lack of another option—with usual sources of primary care."
I'm still not convinced that "linking" patients to a primary care provider will have a significant impact on ED utilization, result in overall healthcare cost reduction, or improve patient outcome. Call me crazy.
I think, rather than putting so much effort, time, and $ into "linking" a patient with a primary care provider, we should improve our abilities to care for these patients in the Emergency Department. In my opinion, it is much more difficult to change well established patient behavior. It is much easier, less costly, and possibly outcome positive, to MODIFY OUR RESPONSE to patient behavior.
People are going to come to the ED regardless. We should do a better job of meeting their primary care needs on location...not spend timely/costly effort trying to send them somewhere else. That to me...is crazy.
"Though intervention patients trended toward having reduced postintervention ED visits, results were not statistically significant. In addition, the numbers of visits were small and of unclear clinical significance. Our intervention targeted all visitors, who mostly had low levels of ED use at baseline. Attempts to decrease nonurgent ED use, particularly among patients who are already infrequent users of EDs, are unlikely to significantly decrease ED crowding or costs.35, 36, 37, 38, 39, 40, 41 On the other hand, increased primary care linkage might result in improved care for chronic health conditions affecting millions of people, which could lead to long-term cost savings. As future health reforms begin financially rewarding hospitals for care coordination and quality of services rather than quantity, there will be increasing incentives for programs like ours that connect ED patients to a primary care home. In addition, as more Americans obtain health insurance, there will be a need to link these newly insured—who may initially seek ED care for lack of another option—with usual sources of primary care."
ReplyDeleteI'm still not convinced that "linking" patients to a primary care provider will have a significant impact on ED utilization, result in overall healthcare cost reduction, or improve patient outcome. Call me crazy.
ReplyDeleteI think, rather than putting so much effort, time, and $ into "linking" a patient with a primary care provider, we should improve our abilities to care for these patients in the Emergency Department. In my opinion, it is much more difficult to change well established patient behavior. It is much easier, less costly, and possibly outcome positive, to MODIFY OUR RESPONSE to patient behavior.
People are going to come to the ED regardless. We should do a better job of meeting their primary care needs on location...not spend timely/costly effort trying to send them somewhere else. That to me...is crazy.