After-Hours Access To Primary Care Practices Linked With Lower Emergency Department Use And Less Unmet Medical Need

Primary Care Attributes Associated with Receipt of Preventive Care Services: A National Study

“…29,30 In addition, patients who value extended access may be more likely to seek out practices that offer it and to recognize (and report) that it is available, and such individuals may place a lower premium on prevention. While extended office hours have been associated with lower overall health care costs and fewer emergency department visits, 5,6 these findings underscore the need for further investigation of their impact on care outcomes, including preventive care. The analysis of primary care attributes score by quartiles showed a gradient of respondents reporting prevention compliance from lowest to highest quartiles.…”

“…4 The joint principles also add further attributes to the definition of the PCMH, including enhanced access to care (eg, availability of evening and weekend office hours), which has previously been associated with less emergency department use and fewer total health care expenditures. 5,6 Despite the emphasis placed on comprehensiveness, patient-centeredness, and extended access in prevailing health care redesign efforts, how these attributes influence utilization of preventive services at the national level is little studied. Existing research consists of ecological studies, 7 small pilot projects, 8 and larger comparative studies.…”

Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs

“…43,44 Likewise, access to after-hours care coordinated with the primary care provider is associated with lower rates of hospitalization and emergency department use, greater patient satisfaction and fewer unmet medical needs. [45][46][47][48] Continuity also has various components, including informational continuity (the availability of a patient's health information at the point of care), continuity with the same practice over time, and interpersonal continuity with the same clinician over time. 4,5,49,50 These last two aspects are the concepts most often referenced in primary care research; they have been associated with lower hospitalization rates, [51][52][53][54][55][56] lower complication rates for patients with chronic conditions, 55 fewer emergency room visits, 57,58 lower total costs 53 and lower episodebased costs for chronic conditions.…”

Patient Motivators for Emergency Department Utilization: A Pilot Cross-Sectional Survey of Uninsured Admitted Patients at a University Teaching Hospital

“…Recent studies estimate that between 10% and 30% of ED visits are for nonurgent conditions (3). Such ED utilization has been attributed to barriers in timely and efficient access to primary care, lack of transportation, cost of care, wait times, and opening hours (4)(5)(6)(7)(8)(9). Some studies suggest that patients insured through the Affordable Care Act (ACA) will increase ED utilization rates (10,11).…”