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

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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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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: Brousseau, David C.
Nattinger, Ann B.
Flores, Glenn
Zhang, Yinghua
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 › Medicine › Family Practice › 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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Quality of Primary Care and Subsequent Pediatric Emergency Department Utilization

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