scholarly journals Effect of Access to After-Hours Primary Care on the Association Between Home Nursing Visits and Same-Day Emergency Department Use

2020 ◽  
Vol 18 (5) ◽  
pp. 406-412
Author(s):  
Aaron Jones ◽  
Susan E. Bronskill ◽  
Connie Schumacher ◽  
Hsien Seow ◽  
David Feeny ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Home Nursing ◽  
Emergency Department Use ◽  
After Hours

scholarly journals Comparing primary care Interprofessional and non-interprofessional teams on access to care and health services utilization in Ontario, Canada: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wissam Haj-Ali ◽  
Brian Hutchison ◽  
Rahim Moineddin ◽  
Walter P. Wodchis ◽  
Richard H. Glazier
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Access To Care ◽  
Retrospective Cohort ◽  
Emergency Department Use ◽  
Services Utilization ◽  
Interprofessional Teams ◽  
Primary Care Teams ◽  
Patient Reported ◽  
After Hours

Abstract Background Many countries, including Canada, have introduced primary care reforms to improve health system functioning and value. The purpose of this study was to examine the association between receiving care from interprofessional primary care teams and after-hours access to care, patient-reported walk-in clinic visits and emergency department use. Methods We conducted a retrospective cohort study linking population-based administrative databases to Ontario’s Health Care Experience Survey (HCES) between 2012 and 2018. We adjusted for physician group characteristics as well as individual physician and patient characteristics while assessing the relationship between receiving care from interprofessional teams and the outcomes of interest. Results As of March 31st, 2015, there were 465 physician groups with HCES respondents of which 177 (38.0%) were interprofessional teams and 288 (62.0%) were non-interprofessional teams in the same blended capitation reimbursement model. In this period, there were 4518 physicians with HCES respondents, of whom 2131 (47.2%) were in interprofessional teams and 2387 (52.8%) were in non-interprofessional teams. There were 10,102 HCES respondents included in this study, of whom 42.4% were in interprofessional teams and 42.3% were in non-interprofessional teams. After adjustment, we found that being in an interprofessional team was associated with an increase in the odds of patients reporting same/next day access to care by 12.0% (OR = 1.12 CI = 1.00 to 1.24 p-value 0.0436) and a decrease in the odds of patients reporting walk-in clinic use by 16% (OR = 0.84 CI = 0.75 to 0.94 p-value 0.0019). After adjustment, there were no significant differences in patient-reported after-hours access to care and emergency department use. Conclusions Ontario has invested heavily in interprofessional primary care teams. As compared to patients in non-interprofessional teams, patients in interprofessional teams self-reported more timely access to care and less walk-in clinic use but no significant difference in self-reported access to after-hours care or in emergency department use. For jurisdictions aiming to expand physician voluntary participation in interprofessional teams, our study results inform expectations around access to care and health services utilization.

Using Google Trends to track walk-in clinic and emergency department searches over time and across provinces in Canada (Preprint)

2019 ◽  
Author(s):  
Joseph Ssendikaddiwa ◽  
Ruth Lavergne
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
British Columbia ◽  
Emergency Departments ◽  
Google Trends ◽  
Care Seeking ◽  
Primary Care Access ◽  
Care Access ◽  
After Hours ◽  
Over Time

BACKGROUND Access to primary care is a challenge for many Canadians. Models of primary care vary widely across provinces, including arrangements for same day and after-hours access. Use of walk-in clinics and emergency departments may also vary, but data sources that allow comparison are limited. OBJECTIVE We use Google Trends to examine searches for walk-in clinics and emergency departments across provinces and over time in Canada, and compare results to other information about primary care access. METHODS We developed search strategies to capture the range of terms used for walk-in clinics (e.g. urgent care clinic, after-hours clinic) and emergency departments (e.g. ER, emergency room) across Canadian provinces. We used Google Trends to determine the frequencies of these terms relative to total search volume, and standardized search frequencies to allow comparisons across provinces and over time (2011-2018). We explored how care seeking captured by Google Trends correlates with other sources of data on primary care access by province. RESULTS Manitoba, British Columbia, and Nova Scotia had highest search frequency for emergency departments, and Saskatchewan, Alberta, and Ontario had the lowest. Searches for walk-in clinics were most common in the western provinces of British Columbia, Alberta, and Saskatchewan. Relative search frequency for walk-in clinics increased steadily, doubling in most provinces between 2011 and 2018. Higher search frequency for walk-in clinics was correlated with ability to get a same or next-day appointment and inversely correlated with both ED use for conditions treatable in patients’ regular place of care and having a regular medical provider. Emergency department searches were not correlated with survey data. CONCLUSIONS Search frequencies may reflect patient care seeking but may also be impacted by news coverage and other events, especially in the case of emergency department searches. We observe substantial interprovincial variation, and marked growth in the frequency of searches for walk-in clinics. Google Searches for walk-in clinics correlate with other measures of access, and appear to correspond to differences in policies related to walk-in clinics, advanced access, and after-hours care between provinces.

scholarly journals Association of Patients’ Perception of Primary Care Provider Listening With Emergency Department Use

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Katie Hinderaker ◽  
Amanda Weinmann
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Providers ◽  
California Health Interview Survey ◽  
Care Providers ◽  
Emergency Department Use ◽  
Younger Age ◽  
Interview Survey ◽  
Ed Visits ◽  
African American Race

Introduction: This study examined whether patients’ perceptions of their primary care providers’ (PCP) listening frequency were associated with emergency department (ED) utilization, including a comparison to patients without PCPs. Methods: Data were obtained from the 2015 California Health Interview Survey. Respondents were asked if they had a PCP and how often their PCPs listened, resulting in five groups: patients without a PCP (n=4,407), and patients with a PCP who perceived the PCP’s listening frequency to be never (n=254), sometimes (n=1,282), usually (n=3,440), or always (n=11,651). Multiple linear regression was performed to determine if patient-perceived listening frequency of the PCP was associated with the patient’s number of ED visits in the prior year, adjusting for various demographic, social, and health factors. Results: Compared to patients without a PCP, patients with a PCP had on average 0.15 more ED visits in a year, highest among those whose PCPs were perceived as listening the least: never=0.55 more visits per year (95% CI: 0.09-1.02, P=.02), sometimes=0.26 (0.01-0.51, P=.04), usually=0.03 (-0.17-0.24, P=.73), and always=0.16 (-0.05-0.36, P=.13). Other significant increases in ED visits were associated with public insurance, African-American race, English proficiency, younger age, self-rated fair-to-poor health, asthma, and hypertension. Conclusions: Patients who perceived their PCP as listening less frequently had more ED visits than patients whose PCPs were perceived as listening more frequently, and compared to patients without a PCP.

Sign in / Sign up

Export Citation Format

Share Document