PEDIATRICS Vol. 95 No. 1 January 1995, pp. 37-41
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Is Continuity of Care Preserved in Children Who Utilize the Pediatric Emergency Department?

Patrick M. Vivier MD1, William J. Lewander MD2, Stanley H. Block MD3, Peter R. Simon MD4, Anthony J. Alario MD5, and James G. Linakis PhD, MD2

1 The Division of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD
2 Division of Pediatric Emergency Medicine and the Section of Emergency Medicine, Brown University, Rhode Island Hospital, Providence, RI
3 Providence Ambulatory Health Care Foundation, Rhode Island Department of Health; Providence, RI
4 Division of Family Health, Rhode Island Department of Health; Providence, RI
5 Department of Pediatrics, Brown University, Rhode Island Hospital, Providence, RI

Room 490, Hampton House, School of Hygiene & Public Health, Johns Hopkins University, Baltimore, MD 21205.

Objective. Inner city families often use multiple sites for nonemergent medical care, including the pediatric emergency department. This practice raises concerns about continuity of care. The present study examined one aspect of continuity of care: Do children who receive care in a pediatric emergency department return to their primary care site so that appropriate follow up may be obtained?

Methods. Over a 4-week period two groups of neighborhood health center children were studied: Those who sought care at the pediatric emergency department and those who were "walk-ins" at the health centers. All visits during the 4-week study period which resulted in a recommendation for the child to be seen within 6 weeks at the health centers were included in the analysis.

Results. During the study period there were 87 patient visits to the pediatric emergency department with a documented physician instruction to be seen at their health center within 6 weeks. In 66 (76%) of the cases, the patient was seen at one of the health centers during the 6 weeks following the pediatric emergency department visit. There were 146 "walk-in" visits to the health centers with a documented physician instruction to be seen again at the health centers during the 6 weeks following the walk-in visit. In 111 (76%) of the cases, the patient was seen during the 6-week period.

Conclusion. Our study shows that revisit rates were comparable for the two groups. We conclude that the rate of compliance with follow-up recommendations is similar for those who utilized the pediatric emergency department versus those who used the primary care site.

Submitted on February 2, 1994
Accepted on April 25, 1994




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