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Connecting Emergency Department Patients to Primary Care.将急诊科患者与初级保健相联系。
J Am Board Fam Med. 2015 Nov-Dec;28(6):722-32. doi: 10.3122/jabfm.2015.06.150044.
2
Decreasing nonurgent emergency department utilization by Medicaid children.降低医疗补助儿童非紧急情况下急诊部门的利用率。
Pediatrics. 1998 Jul;102(1 Pt 1):20-4. doi: 10.1542/peds.102.1.20.
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National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries.全国性研究：医疗补助受益人群及时获得初级保健和急诊服务的障碍。
Ann Emerg Med. 2012 Jul;60(1):4-10.e2. doi: 10.1016/j.annemergmed.2012.01.035. Epub 2012 Mar 13.
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Association of Medicare and Medicaid insurance with increasing primary care-treatable emergency department visits in the United States.美国医疗保险和医疗补助保险与初级保健可治疗的急诊就诊增加之间的关联。
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Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-affordable Care Act Medicaid Expansion?《平价医疗法案》扩大医疗补助计划后，俄勒冈州医疗补助计划的参保者在哪里寻求门诊治疗？
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The effect of emergency department copayments for Medicaid beneficiaries following the Deficit Reduction Act of 2005.2005 年《减赤法案》实施后，对医疗补助受益人的急诊共付额的影响。
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J Perinat Med. 2025 May 27. doi: 10.1515/jpm-2025-0095.
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A mapping review of interventions to address patients who frequently seek care in the emergency department.针对频繁到急诊科就诊的患者的干预措施的映射回顾。
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Int J Emerg Med. 2019 Nov 21;12(1):35. doi: 10.1186/s12245-019-0254-7.
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Patient navigators facilitating access to primary care: a scoping review.患者导航员促进初级保健服务的获取：一项范围综述
BMJ Open. 2018 Mar 17;8(3):e019252. doi: 10.1136/bmjopen-2017-019252.
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Public Health, Hypertension, and the Emergency Department.公共卫生、高血压与急诊科
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本文引用的文献

1
Decision-making processes of patients who use the emergency department for primary care needs.因初级保健需求而使用急诊科的患者的决策过程。
J Health Care Poor Underserved. 2013 Aug;24(3):1288-305. doi: 10.1353/hpu.2013.0140.
2
An intervention connecting low-acuity emergency department patients with primary care: effect on future primary care linkage.将低危急诊科患者与初级保健相连接的干预措施：对未来初级保健衔接的影响。
Ann Emerg Med. 2013 Mar;61(3):312-321.e7. doi: 10.1016/j.annemergmed.2012.10.021. Epub 2012 Dec 20.
3
Patient-centered care and emergency department utilization: a path analysis of the mediating effects of care coordination and delays in care.以患者为中心的护理和急诊科利用：护理协调和护理延迟的中介效应的路径分析。
Med Care Res Rev. 2012 Oct;69(5):560-80. doi: 10.1177/1077558712453618. Epub 2012 Jul 19.
4
Effectiveness of organizational interventions to reduce emergency department utilization: a systematic review.组织干预措施降低急诊科利用效果的系统评价。
PLoS One. 2012;7(5):e35903. doi: 10.1371/journal.pone.0035903. Epub 2012 May 2.
5
Comparative effectiveness of care coordination interventions in the emergency department: a systematic review.比较急诊科护理协调干预措施的效果：系统评价。
Ann Emerg Med. 2012 Jul;60(1):12-23.e1. doi: 10.1016/j.annemergmed.2012.02.025. Epub 2012 Apr 27.
6
National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries.全国性研究：医疗补助受益人群及时获得初级保健和急诊服务的障碍。
Ann Emerg Med. 2012 Jul;60(1):4-10.e2. doi: 10.1016/j.annemergmed.2012.01.035. Epub 2012 Mar 13.
7
Emergency department visitors and visits: who used the emergency room in 2007?急诊科就诊者与就诊情况：2007年谁使用了急诊室？
NCHS Data Brief. 2010 May(38):1-8.
8
Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses.比较零售诊所与其他医疗场所针对3种常见疾病的护理成本和质量。
Ann Intern Med. 2009 Sep 1;151(5):321-8. doi: 10.7326/0003-4819-151-5-200909010-00006.
9
Inappropriate use of emergency services: a systematic review of prevalence and associated factors.急诊服务的不当使用：患病率及相关因素的系统评价
Cad Saude Publica. 2009 Jan;25(1):7-28. doi: 10.1590/s0102-311x2009000100002.
10
Impact of an internet-based emergency department appointment system to access primary care at safety net community clinics.基于互联网的急诊科预约系统对安全网社区诊所获得初级保健服务的影响。
Ann Emerg Med. 2009 Aug;54(2):279-84. doi: 10.1016/j.annemergmed.2008.10.030. Epub 2008 Dec 13.

将急诊科患者与初级保健相联系。

Connecting Emergency Department Patients to Primary Care.

作者信息

Wexler Randell, Hefner Jennifer L, Sieck Cynthia, Taylor Christopher A, Lehman Jennifer, Panchal Ashish R, Aldrich Alison, McAlearney Ann Scheck

机构信息

From the Department of Family Medicine, College of Medicine (RW, JLH, CS, CAT, JL, AA, ASM), the School of Health and Rehabilitation Sciences (CAT), the Department of Emergency Medicine, College of Medicine (ARP), and the Division of Health Services Management and Policy, College of Public Health (ASM), The Ohio State University, Columbus.

出版信息

J Am Board Fam Med. 2015 Nov-Dec;28(6):722-32. doi: 10.3122/jabfm.2015.06.150044.

DOI:10.3122/jabfm.2015.06.150044
PMID:26546647
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11999026/
Abstract

BACKGROUND

Inappropriate emergency department (ED) use among Medicaid enrollees is considered a problem because of cost. We developed and evaluated a system change innovation designed to remove system barriers to primary care access for Medicaid patients.

METHODS

Patients who presented to the ED without an identified primary care provider were randomized to the intervention (n = 72) or comparison group (n = 68) for a 12-month study designed to connect these patients to primary care offices. Evaluation was mixed quantitative/qualitative.

RESULTS

Significantly more intervention participants attended at least 1 primary care visit 3 months after the intervention (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.06-6.02), though this difference was not significant by 12 months (OR, 1.74; 95% CI, 0.79-3.84). The intervention participants also did not have lower odds of returning to the ED for nonurgent reasons by the 12-month follow-up (OR, 1.27; 95% CI, 0.65-2.48). Patient-reported barriers to attending a primary care appointment were primarily social and health system-related factors.

CONCLUSION

The intervention did not decrease ED visits nor increase primary care use over the 12 months of the study period. The qualitative results provide insight into nonurgent ED utilization by patients with Medicaid, suggesting potential future interventions.

摘要

背景

由于成本问题，医疗补助计划参保者在急诊科（ED）的不当使用被视为一个问题。我们开发并评估了一项系统变革创新措施，旨在消除医疗补助患者获得初级医疗服务的系统障碍。

方法

对于那些在急诊科就诊但未确定初级医疗服务提供者的患者，在一项为期12个月的研究中，将他们随机分为干预组（n = 72）或对照组（n = 68），该研究旨在将这些患者与初级医疗办公室联系起来。评估采用定量和定性相结合的方式。

结果

干预组中显著更多的参与者在干预后3个月至少进行了1次初级医疗就诊（优势比[OR]，2.52；95%置信区间[CI]，1.06 - 6.02），不过到12个月时这种差异并不显著（OR，1.74；95% CI，0.79 - 3.84）。在12个月的随访中，干预组参与者因非紧急原因返回急诊科的几率也没有降低（OR，1.27；95% CI，0.65 - 2.48）。患者报告的参加初级医疗预约的障碍主要是社会和卫生系统相关因素。

结论

在研究期间的12个月内，该干预措施既没有减少急诊科就诊次数，也没有增加初级医疗服务的使用。定性结果为了解医疗补助患者非紧急情况下急诊科的使用情况提供了见解，提示了未来可能的干预措施。