Linking emergency department patients to primary care: Phone vs face-to-face interaction

Objective: To compare the patient compliances and time analyses of two meth ods of assigning primary care providers (PCPs) to ED patients who are witho ut a PCP: phone interview vs face-to-face interaction. Methods: Prospective observational cohort study following an intervention, performed in a pedia tric ED, serving a population of 1.7 million, with a census of 80,000 pedia tric ED visits per year. Over one year, a consecutive sampling of 1,062 pat ients evaluated in the ED and without a PCP were approached to participate in our study (536 enrolled, 526 declined). Patients enrolled were addressed by a nurse practitioner/social worker (NP/SW) who arranged an appointment with a PCP, either in person (in ED) or by phone after discharge. The prima ry outcome measure was compliance with the arranged appointment. Secondaril y, the authors analyzed the time necessary for each approach in person-hour s. Results: Of the 536 enrolled, 81 were excluded because data collection w as incomplete at the time of the study's completion, leaving 455 study pati ents. Seventy-six percent of the study patients were between the ages of 1 month and 12 years. Contact was made by phone for 151 (33%) patients and fa ce-to-face for 304 (67%). Sixty-two percent of the phone patients kept thei r appointments, compared with 52% of face-to-face patients (p = 0.048, RR = 1.20, 1.02 < RR < 1.41). Phone interaction was also more time effective. C onclusion: Linking ED patients without a medical provider to PCPs via phone is as effective as a face-to-face interaction.