Impact of a Novel Referral Program From a Children's Hospital Emergency Department to Primary Care: Does Referral Lead to Improved Care?
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| Titel: | Impact of a Novel Referral Program From a Children's Hospital Emergency Department to Primary Care: Does Referral Lead to Improved Care? |
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| Autoren: | Kanak M; Children's Hospital Los Angeles.; Keck School of Medicine of University of Southern California, Los Angeles., Pierce J; Northern Valley Indian Health, Chico., Rosario A; Keck School of Medicine of University of Southern California, Los Angeles.; Los Angeles General Medical Center, Los Angeles, CA., Hall JE; Children's Hospital Los Angeles.; Keck School of Medicine of University of Southern California, Los Angeles., Liberman DB; Children's Hospital Los Angeles.; Keck School of Medicine of University of Southern California, Los Angeles., Rezvan PH; Children's Hospital Los Angeles.; Keck School of Medicine of University of Southern California, Los Angeles., Patel M; Children's Hospital Los Angeles.; Keck School of Medicine of University of Southern California, Los Angeles. |
| Quelle: | Pediatric emergency care [Pediatr Emerg Care] 2025 Nov 01; Vol. 41 (11), pp. 859-863. Date of Electronic Publication: 2025 Jul 15. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8507560 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-1815 (Electronic) Linking ISSN: 07495161 NLM ISO Abbreviation: Pediatr Emerg Care Subsets: MEDLINE |
| Imprint Name(s): | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Baltimore, Md. : Williams & Wilkins, [c1985- |
| MeSH-Schlagworte: | Referral and Consultation*/statistics & numerical data , Referral and Consultation*/organization & administration , Emergency Service, Hospital*/statistics & numerical data , Emergency Service, Hospital*/organization & administration , Primary Health Care*/organization & administration , Primary Health Care*/statistics & numerical data , Hospitals, Pediatric*/statistics & numerical data , Hospitals, Pediatric*/organization & administration, Humans ; Retrospective Studies ; Male ; Female ; Child ; Child, Preschool ; Infant ; Adolescent ; Health Services Accessibility ; Preventive Health Services/statistics & numerical data ; Appointments and Schedules ; Hospitalization/statistics & numerical data |
| Abstract: | Competing Interests: Disclosure: The authors declare no conflict of interest. Objectives: Interventions to connect pediatric Emergency Department (PED) patients to primary care are needed to improve preventive care access and reduce ED overcrowding. This study aimed to assess the impact of a novel PED-to-primary care referral program on preventive care utilization and ED and hospital visit rates. Methods: We instituted a new electronic referral program in which clinicians referred PED patients lacking or requesting a new primary care physician (PCP) to a partner federally qualified health center (FQHC) network. We then conducted a retrospective chart review of all referred patients between January 2020 (program inception) and June 2022 to evaluate the program in two ways. For all referrals, we assessed operational metrics: the number of patients referred, reached by phone, scheduled for an appointment, and completed an appointment. For the first 500 referrals, we further evaluated demographic characteristics associated with appointment completion, preventive care services received, and the number of post-referral ED visits and hospitalizations. Results: Overall, the PED referred 1778 patients. FQHC family navigators successfully contacted 1293 patients within 3 days. Of those contacted, 576 had appointments scheduled, and 372 patients (20.9% of total referrals) completed an appointment within 30 days. Among the first 500 referrals, no demographic characteristics were associated with appointment completion. Patients who completed an appointment presented with immunization delays, abnormal hemoglobin or lead levels, and food insecurity. We found no reduction in ED or hospital utilization postreferral. Conclusions: While less than one third of referred PED patients completed timely primary care physician appointments, those who did demonstrated significant preventive service needs. Further studies should explore the substantial attrition between PED referral and PCP appointment completion. (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.) |
| References: | Child and Adolescent Health Measurement Initiative. 2021-2022 National Survey of Children’s Health (NSCH) data query: Health Care Access and Quality Data Resource Center for Child and Adolescent Health supported by the US. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB); 2024. Howle E Report Number: 2018-111: Millions of Children in Medi-Cal Are Not Receiving Preventive Health Services .; 2019. Accessed June 6, 2024. https://information.auditor.ca.gov/pdfs/reports/2018-111.pdf. Chung PJ, Lee TC, Morrison JL, et al. Preventive care for children in the United States: quality and barriers. Annu Rev Public Health. 2006;27:491–515. Giannouchos TV, Washburn DJ, Gary JC, et al. Frequent emergency department use in the paediatric population: a systematic literature review. J Eval Clin Pract. 2021;27:193–203. Cecil E, Bottle A, Cowling TE, et al. 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| Contributed Indexing: | Keywords: ED overcrowding; access to care; preventive care; program evaluation; underserved patients |
| Entry Date(s): | Date Created: 20250715 Date Completed: 20251030 Latest Revision: 20251030 |
| Update Code: | 20251030 |
| DOI: | 10.1097/PEC.0000000000003449 |
| PMID: | 40660766 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Disclosure: The authors declare no conflict of interest.<br />Objectives: Interventions to connect pediatric Emergency Department (PED) patients to primary care are needed to improve preventive care access and reduce ED overcrowding. This study aimed to assess the impact of a novel PED-to-primary care referral program on preventive care utilization and ED and hospital visit rates.<br />Methods: We instituted a new electronic referral program in which clinicians referred PED patients lacking or requesting a new primary care physician (PCP) to a partner federally qualified health center (FQHC) network. We then conducted a retrospective chart review of all referred patients between January 2020 (program inception) and June 2022 to evaluate the program in two ways. For all referrals, we assessed operational metrics: the number of patients referred, reached by phone, scheduled for an appointment, and completed an appointment. For the first 500 referrals, we further evaluated demographic characteristics associated with appointment completion, preventive care services received, and the number of post-referral ED visits and hospitalizations.<br />Results: Overall, the PED referred 1778 patients. FQHC family navigators successfully contacted 1293 patients within 3 days. Of those contacted, 576 had appointments scheduled, and 372 patients (20.9% of total referrals) completed an appointment within 30 days. Among the first 500 referrals, no demographic characteristics were associated with appointment completion. Patients who completed an appointment presented with immunization delays, abnormal hemoglobin or lead levels, and food insecurity. We found no reduction in ED or hospital utilization postreferral.<br />Conclusions: While less than one third of referred PED patients completed timely primary care physician appointments, those who did demonstrated significant preventive service needs. Further studies should explore the substantial attrition between PED referral and PCP appointment completion.<br /> (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.) |
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| ISSN: | 1535-1815 |
| DOI: | 10.1097/PEC.0000000000003449 |