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Cited by 145Emergency and Acute Care StudiesPrimary Care and Health OutcomesHealthcare Policy and Management

Quality of Primary Care and Subsequent Pediatric Emergency Department Utilization

Brousseau, David C., Hoffmann, Raymond G., Nattinger, Ann B., Flores, Glenn, Zhang, Yinghua, Gorelick, Marc·2007·Pediatrics
DOI 10.1542/peds.2006-3518
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Abstract

OBJECTIVE. Our objective was to determine whether parent-reported, high-quality primary care was associated with decreased nonurgent pediatric emergency department utilization. METHODS. A retrospective analysis of prospectively collected data for a cohort of children from the 2000–2001 and 2001–2002 Medical Expenditure Panel Survey panels was performed. Baseline parent-reported quality of primary care with respect to family-centeredness, timeliness, and realized access (a measure of the child's ability to receive necessary care and referrals) was assessed by using composite scores from the Consumer Assessment of Healthcare Providers and Systems survey. The primary outcomes were the numbers of subsequent nonurgent and urgent emergency department visits per child. RESULTS. Of 8823 children included, 70.0% rated family-centeredness, 88.2% rated realized access, and 55.6% rated timeliness as high quality. After adjustment for demographic factors and health status, high-quality family-centeredness was associated with a 42% reduction in nonurgent emergency department visits for publicly insured children and a 49% reduction for children ≤2 years of age. Greater realized access was associated with a 44% reduction in nonurgent emergency department visits for children 3 to 11 years of age and a 56% reduction for children ≥12 years of age. Greater realized access was also associated with decreased nonurgent emergency department visits for publicly and privately insured children (37% and 35%, respectively). There was no significant association between timeliness and nonurgent emergency department utilization, nor was any quality-of-care domain associated with urgent emergency department utilization. CONCLUSIONS. Parent-reported, high-quality family-centeredness and a high level of realized access to primary care were associated with decreased subsequent nonurgent emergency department visits for children. Parent reports of health care quality in these domains provide important complementary information on health care quality.

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  • An index of family-centeredness based on the Consumer Assessment of Healthcare Providers and Systems survey has been used in national surveys.

    “An index of family-centeredness based on the Consumer Assessment of Healthcare Providers and Systems survey has been used in national surveys [86, 87].”

    From Family-Centered Care: Current Applications and Future Directions in Pediatric Health Care (2012) · cites this paper as [87]

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Authors
Brousseau, D. C., Hoffmann, R. G., Nattinger, A. B., Flores, G., Zhang, Y., & Gorelick, M.
Affiliations
  • Department of Pediatrics, Children's Research Institute
  • Department of Population Health
  • Children's Hospital of Wisconsin (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2007-06-01
Volume
119
Issue
6
Pages
1131-1138
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2006-3518
OpenAlex
W2163425579
Cited by
145
References
40
Citations by year
2026: 5 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 7 · 2021: 11 · 2020: 11 · 2019: 5 · 2018: 9 · 2017: 14 · 2016: 8 · 2015: 6 · 2014: 10 · 2013: 11 · 2012: 10
FWCI
7.59
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
Agency for Healthcare Research and Quality (K08 HS015482-01A)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
primary care quality, pediatric emergency department utilization, non-urgent emergency visits, family-centeredness, timeliness of care, publicly insured children, urgent care visits
MeSH terms
Adolescent, Child, Child, Preschool, Emergency Service, Hospital, Female, Humans, Infant, Infant, Newborn, Male, Primary Health Care, Prospective Studies, Quality of Health Care, Retrospective Studies, Cohort Studies

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