Gaps in Primary Care Exist After Emergency Department Visits

Medicaid-insured beneficiaries less likely to receive prompt primary care following an emergency department visit.

Primary care physicians (PCPs) play a crucial role in patient care and disease prevention. Receiving regular preventive care and screenings from PCPs are important for remaining healthy and preventing adverse health events.

A new study published by the Annals of Emergency Medicine found that just one-third of patients who do not have a PCP and visit the emergency department (ED) were able to be receive a primary care appointment within 1 week of the initial hospital visit.

Specifically, the authors noted that Medicaid-insured patients and those experiencing back pain were the least likely to receive primary care after an ED visit.

After treatment in the ED, providers often recommend that patients receive prompt follow-up care from a PCP; however, many patients fail to make timely appointments, according to the study.

In the study, 2 individuals posed as different patients who were instructed to request primary care appointments. The individuals pretended to be patients with commercial, Affordable Care Act, or Medicaid insurance who had back pain or hypertension and recently received care in the ED. The patients made more than 600 calls to more than 50 primary care practices.

The study authors discovered that only 31% of the calls resulted in appointments offered within a week of the ED visit. Patients insured by Medicaid were the least likely to receive a prompt appointment, with a 7-day success rate of 26%, according to the study.

“The most significant finding is that only a third of patients can get into primary care within a week,” said lead author Shih-Chuan Chou, MD, MPH.

The authors noted that their findings were significantly lower than what previous studies showed.

The investigators also found that the condition a patient presented with impacted the time it took to get an appointment.

Only 28% of patients with back pain and 34% of patients with hypertension received follow-up care within 1 week, according to the study. The varying success rates may be caused by the perception that patients with back pain are seeking treatment with opioids.

These findings underscore the gaps in care that may be faced by patients who sought care from the ED.

“For patients newly covered by Medicaid or the exchange, who likely did not have a primary care physician, it’s very hard for them to get an appointment even after an ED visit,” Dr Chou said.

Although the 7-day and overall appointment rates were low, the authors said there is an opportunity for ED providers and PCPs to collaborate and improve the transition of care, the study concluded.