Key result
Primary care office hours are not linked to 48-hour return visits to pediatric EDs.
Why the study?
Does opening off-hour primary care clinics decrease the 48-hour return visit rate to a pediatric emergency department?
Observational (n=30,231)
No
Does opening off-hour primary care clinics decrease the 48-hour return visit rate to a pediatric emergency department?
Opening off-hour primary care clinics is unlikely to significantly decrease 48-hour return visits to the pediatric emergency department.
Should not yet change primary care hours; leaves open other drivers of pediatric ED returns.
OBJECTIVE: The aim of this study was to evaluate the influence of primary care office hours of operation on 48-hour return visits (RVs) to a pediatric emergency department (ED). We compared characteristics of patients who return with those who follow up outpatient to determine the feasibility of opening off-hour clinics to decrease the RV rate. METHODS: The study was a retrospective chart review of patients presenting to a pediatric ED for a 3-year period. A subset of patients with a hospital-affiliated primary care provider was evaluated to compare those with 48-hour ED RVs with those with office follow-up. RESULTS: Patients with a hospital-affiliated primary care provider had 30,231 visits, of whom 842 had a 48-hour return (2.79%). A significant number (48.5%) of those who returned had seen their primary care doctor between emergency visits. The percentage of RVs occurring at night (55.7%) was slightly lower than the percentage of all visits occurring off hours (58.1%). Patients with more acute presentation at initial visit (emergency severity index level acuity 2, >20 orders placed) were more likely to follow up with their provider than return to the ED. CONCLUSIONS: The findings from this study show no significant increase in RVs during the evening and overnight hours and many patients with outpatient follow-up before returning to the ED. Opening a clinic at our hospital during nontraditional hours would not likely significantly decrease RV rate.
No takes yet. Share an insight, caveat, or question.
Rogers et al. (2016) conducted an observational in Pediatric emergency department visits (n=30,231). Primary care office hours of operation vs. Traditional hours was evaluated on 48-hour return visits to a pediatric ED. Primary care office hours of operation did not significantly influence 48-hour return visits to a pediatric ED, with 55.7% of return visits occurring at night compared to 58.1% of all visits.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: