Patients lack access to primary care follow-up after ED visit, study finds

Patients discharged from the emergency department often struggle to secure a follow-up with a primary care physician within seven days, according to a study published in Annals of Emergency Medicine.

For the study, researchers recruited two men in New Haven, Conn., to pose as patients recently discharged from the emergency department. The men called all 53 primary care practices in the New Haven area, requesting follow-up appointments with a primary care physician. Each care practice received six calls from the men, who used different scripts for each call. The scripts differed based on the pretend patient's insurance type — Medicaid, state exchange or commercial — and health condition — hypertension or back pain.

The men successfully scheduled an appointment with a primary care provider within one week 30.7 percent of the time, on average. Medicaid patients had a seven-day appointment rate of 25.5 percent, compared to 35.7 percent for privately insured patients. The men were more likely to secure an appointment within seven days for hypertension (33.7 percent) than back pain (27.6 percent).

"Follow-up is an essential component of the outpatient care provided by emergency departments," the authors wrote in the study. "Our findings demonstrate the need for close partnerships between EDs and primary care providers to improve access to acute and primary care."

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