Alteration of emergency room usage in a family practice residency program.

A patient education program was instituted that emphasized the importance of telephoning the physician prior to making an emergency room visit and defined an inappropriate visit in simple terms. The purpose of the program was to reduce the percentage of nonurgent or inappropriate emergency room visits each month. A total of 3,825 emergency room visits were reviewed. The percentage of inappropriate visits dropped from 29 percent in the control period to 18 percent in the patient education period (P less than or equal to .001). This included significant decreases in the four major reimbursement groups: self-paying (P less than or equal to .005), group insurance (P less than or equal to .001), Medical Assistance (P less than or equal .01), and Medicare (P less than or equal to .01). Also during the patient education period there was a trend toward increased telephone calls prior to emergency room visits.