Primary Care Physician Access and Gatekeeping: A Key to Reducing Emergency Department Use
Use of the Emergency Department (ED) for nonurgent conditions results in increased cost and discontinuous health care. This prospective study evaluated a program (KenPAC) that required 24-hour access to a primary care physician (PCP) with ED gatekeeping responsibility. Following established criteria...
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| Veröffentlicht in: | Clinical pediatrics 1997-02, Vol.36 (2), p.63-68 |
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| container_end_page | 68 |
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| container_title | Clinical pediatrics |
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| creator | Franco, Sofia M. Mitchell, Charlene K. Buzon, Rosalia M. |
| description | Use of the Emergency Department (ED) for nonurgent conditions results in increased cost and discontinuous health care. This prospective study evaluated a program (KenPAC) that required 24-hour access to a primary care physician (PCP) with ED gatekeeping responsibility. Following established criteria, medical records were reviewed for appropriateness of ED use by an urban indigent pediatric population. Emergency Department visits declined (10% to 7.6% (P=0.00005) and inappropriate visits dropped (41% to 8%) (P |
| doi_str_mv | 10.1177/000992289703600201 |
| format | Article |
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This prospective study evaluated a program (KenPAC) that required 24-hour access to a primary care physician (PCP) with ED gatekeeping responsibility. Following established criteria, medical records were reviewed for appropriateness of ED use by an urban indigent pediatric population. Emergency Department visits declined (10% to 7.6% (P=0.00005) and inappropriate visits dropped (41% to 8%) (P<0.00001) before KenPAC and after KenPAC, respectively. Parental experience, as judged by age and number of children, played a significant role in ED use. The institution of gatekeeping activity contributed to the reduced overall and inappropriate use of the ED.</description><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Emergency Service, Hospital - economics</subject><subject>Emergency Service, Hospital - utilization</subject><subject>Family Practice - organization & administration</subject><subject>Health participants</subject><subject>Health Services Misuse - statistics & numerical data</subject><subject>Humans</subject><subject>Kentucky</subject><subject>Managed Care Programs</subject><subject>Medical sciences</subject><subject>Prospective Studies</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Referral and Consultation - organization & administration</subject><subject>Telephone - utilization</subject><subject>Triage - organization & administration</subject><subject>United States</subject><subject>Urban Population</subject><issn>0009-9228</issn><issn>1938-2707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9Lw0AQxRdRaq1-AUHYg3iLzu4m2V1vpf5FQRE9eArbyaSmNkndTQ799qa09CJ4Gpj3mzczj7FTAZdCaH0FANZKaawGlQJIEHtsKKwykdSg99lwDURr4pAdhTAHEAoSNWADK4RJrBiyz1dfVs6v-MR54q9fq1Bi6Wo-RqQQuKtzfu9a-iZalvXsmo_5E6142_A3yjvsW_y2Ij-jGlf8hpbOtxXVLf8IdMwOCrcIdLKtI_Zxd_s-eYieX-4fJ-PnCFWq2ygvTH8TgpxSbECLQpEtIJWJtNOEwMZo0ZIwKo5tkRuD6CjGdR_iIkVSI3ax8V365qej0GZVGZAWC1dT04VMGxODim0Pyg2IvgnBU5EtN79nArJ1ntnfPPuhs617N60o341sA-z1863uArpF4V2NZdhhMtFGpEmPXW2w4GaUzZvO130m_y3-BcIRiP0</recordid><startdate>19970201</startdate><enddate>19970201</enddate><creator>Franco, Sofia M.</creator><creator>Mitchell, Charlene K.</creator><creator>Buzon, Rosalia M.</creator><general>SAGE Publications</general><general>Westminster</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19970201</creationdate><title>Primary Care Physician Access and Gatekeeping: A Key to Reducing Emergency Department Use</title><author>Franco, Sofia M. ; Mitchell, Charlene K. ; Buzon, Rosalia M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c367t-df8305c02be48071f3e9f062529b5e094c9c9e183449fd88ccae4c094c04f6ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Emergency Service, Hospital - economics</topic><topic>Emergency Service, Hospital - utilization</topic><topic>Family Practice - organization & administration</topic><topic>Health participants</topic><topic>Health Services Misuse - statistics & numerical data</topic><topic>Humans</topic><topic>Kentucky</topic><topic>Managed Care Programs</topic><topic>Medical sciences</topic><topic>Prospective Studies</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Referral and Consultation - organization & administration</topic><topic>Telephone - utilization</topic><topic>Triage - organization & administration</topic><topic>United States</topic><topic>Urban Population</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Franco, Sofia M.</creatorcontrib><creatorcontrib>Mitchell, Charlene K.</creatorcontrib><creatorcontrib>Buzon, Rosalia M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Franco, Sofia M.</au><au>Mitchell, Charlene K.</au><au>Buzon, Rosalia M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Primary Care Physician Access and Gatekeeping: A Key to Reducing Emergency Department Use</atitle><jtitle>Clinical pediatrics</jtitle><addtitle>Clin Pediatr (Phila)</addtitle><date>1997-02-01</date><risdate>1997</risdate><volume>36</volume><issue>2</issue><spage>63</spage><epage>68</epage><pages>63-68</pages><issn>0009-9228</issn><eissn>1938-2707</eissn><coden>CPEDAM</coden><abstract>Use of the Emergency Department (ED) for nonurgent conditions results in increased cost and discontinuous health care. 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| ispartof | Clinical pediatrics, 1997-02, Vol.36 (2), p.63-68 |
| issn | 0009-9228 1938-2707 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_78840349 |
| source | Access via SAGE; MEDLINE |
| subjects | Biological and medical sciences Child Emergency Service, Hospital - economics Emergency Service, Hospital - utilization Family Practice - organization & administration Health participants Health Services Misuse - statistics & numerical data Humans Kentucky Managed Care Programs Medical sciences Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Referral and Consultation - organization & administration Telephone - utilization Triage - organization & administration United States Urban Population |
| title | Primary Care Physician Access and Gatekeeping: A Key to Reducing Emergency Department Use |
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