The Future of Primary Care

PEDIATRICS ◽  
1991 ◽  
Vol 88 (1) ◽  
pp. 186-187
Author(s):  
RITAMARIE MOSCOLA
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Social Economic ◽  
Emergency Department Visits ◽  
Missed Appointments ◽  
Cultural Changes ◽  
Pediatric Education ◽  
The Social ◽  
The Future ◽  
Physician Relationship

To the Editor.— In the article "Primary Care: The Future of Pediatric Education"1 Dr Alpert addresses many issues facing pediatrics. I agree with his list of problems. However, I doubt that the social, economic, and cultural changes he describes will ever occur. My informal survey of pediatricians in practice is a song of frustration and boredom. The ringing telephone provides the rhythm. How does a patient-physician relationship develop in an environment of missed appointments, 3 AM emergency department visits, and managed care? Many families change physicians whenever employers change health benefits packages.

scholarly journals Validation of an algorithm to determine the primary care treatability of emergency department visits

BMJ Open ◽  
2016 ◽  
Vol 6 (8) ◽  
pp. e011739 ◽  
Author(s):  
Molly Moore Jeffery ◽  
M Fernanda Bellolio ◽  
Julian Wolfson ◽  
Jean M Abraham ◽  
Bryan E Dowd ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Department Visits

scholarly journals Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

2020 ◽  
Vol 11 ◽  
pp. 215013272092627
Author(s):  
Julia Ellbrant ◽  
Jonas Åkeson ◽  
Helena Sletten ◽  
Jenny Eckner ◽  
Pia Karlsland Åkeson
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Characteristics ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
University Hospital ◽  
Pediatric Emergency Department ◽  
Hospital Data ◽  
Cross Sectional ◽  
Ed Visits

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

scholarly journals Variation in emergency department visits for conditions that may be treated in alternative primary care settings

CJEM ◽  
2005 ◽  
Vol 7 (04) ◽  
pp. 252-256 ◽  
Author(s):  
Chris A. Altmayer ◽  
Sten Ardal ◽  
Graham L. Woodward ◽  
Michael J. Schull
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Geographic Variation ◽  
Emergency Department Visits ◽  
Primary Care Settings ◽  
Rural Counties ◽  
Ed Visits ◽  
Care Capacity ◽  
The Relationship

ABSTRACT The purpose of this report is to examine Ontario's geographic variation in emergency department (ED) visits for conditions that may be treated in alternative primary care settings. We studied all visits to Ontario EDs in 2002/03 and calculated county-specific age-standardized rates. Overall in Ontario, there were 3174 ED visits per 100 000 population aged 1-74 for conditions that could be treated in alternate primary care settings, but rates varied widely across counties. They were higher in rural counties with rates up to 7-fold higher than the provincial average. Urban counties had lower rates, some were less than one-third of the provincial average. Further research is needed to determine the relationship between ED utilization and primary care capacity.

scholarly journals The Impact of the “Muslim Ban” Executive Order on Healthcare Utilization in Minneapolis-St. Paul, Minnesota

2020 ◽  
Author(s):  
Elizabeth A. Samuels ◽  
Lilla Orr ◽  
Elizabeth B. White ◽  
Altaf Saadi ◽  
Aasim I. Padela ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Emergency Department ◽  
Healthcare Utilization ◽  
The United States ◽  
Emergency Department Visits ◽  
Executive Order ◽  
Before And After ◽  
Muslim Majority ◽  
The Impact

AbstractObjectiveDetermine whether the 2017 “Muslim Ban” Executive Order impacted healthcare utilization by people born in Order-targeted nations living in the United States.MethodsWe conducted a retrospective cohort study of people living in Minneapolis-St. Paul, MN in 2016-2017 who were: 1) born in Order-targeted nations, 2) born in Muslim-majority nations not listed in the Order, and 3) born in the United States and non-Latinx. Primary outcomes were: 1) primary care visits, 2) missed primary care appointments, 3) primary care diagnoses for stress-responsive conditions, 4) emergency department visits, and 5) emergency department visits for stress-responsive diagnoses. We evaluated visit trends before and after Order issuance using linear regression and differences between study groups using a difference-in-difference analyses.ResultsIn early 2016, primary care visits and stress-responsive diagnoses increased among individuals from Muslim majority nations. Following the Order, there was an immediate increase in emergency department visits among individuals from Order-targeted nations.ConclusionsIncreases in healthcare utilization among people born in Muslim majority countries before and after the “Muslim Ban” likely reflect elevated cumulative stress including the impact of the Order.

scholarly journals Strategic planning under the Local Government Act 2002: towards collaboration or compliance?

2006 ◽  
Vol 2 (2) ◽  
Author(s):  
Mike Reid ◽  
Claudia Scott ◽  
Jeff McNeill
Keyword(s):  
Local Government ◽  
Strategic Planning ◽  
Social Economic ◽  
Well Being ◽  
Audit Report ◽  
Local Authorities ◽  
The Social ◽  
The Future

By July 2006 all 85 local authorities expect to have their 10-year Long Term Council Community Plans (LTCCPs) signed and sealed, and passing muster with an unqualified audit report. The new Local Government Act 2002 (LGA 2002) has provided councils with general empowerment and introduced a new purpose (section 3) for local government: to ‘promote the social, economic, cultural and environmental well-being of communities now and for the future’.

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