Effect of telephone calls from primary care practices on follow-up visits after pediatric emergency department visits: Evidence from the Pediatric Emergency Department Links to Primary Care (PEDLPC) randomized controlled trial

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Abstract

Objective: To test whether follow-up phone calls to counsel families about pediatric emergency department (PED) use and primary care availability made after an index PED visit would modify subsequent PED use. Design: Longitudinal prospective randomized intervention. Setting: An urban academic children's hospital. Patients: A total of 4246 individuals aged 0 to 21 years from each of 4 participating primary care practices recording an index PED visit from April through December 2005. Intervention: Follow-up phone call from the primary care practice within 72 hours of the initial PED visit to counsel about the availability of after-hours advice and when to access the PED. Main Outcome Measures: All subsequent visits to primary care practices, PED, pediatric subspecialists, or for inpatient hospitalization during a 365-day follow-up period. Logistic and ordinary least squares regressions estimated unadjusted and adjusted odds ratios of follow-up visits, controlling for covariates. Results: Of the 2166 intervention subjects, 816 (37.7%) recorded follow-up PED visits compared with 819 (39.4%) of the 2080 control subjects (P=.26, not significant). The adjusted odds of a follow-up visit being to the PED rather than to another venue was significantly less for intervention than for control subjects (odds ratio, 0.88; confidence interval, 0.82-0.94), indicating decreased intensity of PED use. Conclusion: Follow-up phone calls from primary care practices after PED visits counseling patients on the use of primary care and emergency services can modulate subsequent care-seeking behavior and decrease future PED use.

Original languageEnglish (US)
Pages (from-to)505-511
Number of pages7
JournalArchives of Pediatrics and Adolescent Medicine
Volume163
Issue number6
DOIs
StatePublished - Jun 2009

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Telephone
Hospital Emergency Service
Primary Health Care
Randomized Controlled Trials
Pediatrics
Odds Ratio
Least-Squares Analysis
Counseling
Inpatients
Hospitalization
Emergencies
Outcome Assessment (Health Care)
Confidence Intervals

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

@article{2742d6fdd4164b829a11ec221334d19f,
title = "Effect of telephone calls from primary care practices on follow-up visits after pediatric emergency department visits: Evidence from the Pediatric Emergency Department Links to Primary Care (PEDLPC) randomized controlled trial",
abstract = "Objective: To test whether follow-up phone calls to counsel families about pediatric emergency department (PED) use and primary care availability made after an index PED visit would modify subsequent PED use. Design: Longitudinal prospective randomized intervention. Setting: An urban academic children's hospital. Patients: A total of 4246 individuals aged 0 to 21 years from each of 4 participating primary care practices recording an index PED visit from April through December 2005. Intervention: Follow-up phone call from the primary care practice within 72 hours of the initial PED visit to counsel about the availability of after-hours advice and when to access the PED. Main Outcome Measures: All subsequent visits to primary care practices, PED, pediatric subspecialists, or for inpatient hospitalization during a 365-day follow-up period. Logistic and ordinary least squares regressions estimated unadjusted and adjusted odds ratios of follow-up visits, controlling for covariates. Results: Of the 2166 intervention subjects, 816 (37.7{\%}) recorded follow-up PED visits compared with 819 (39.4{\%}) of the 2080 control subjects (P=.26, not significant). The adjusted odds of a follow-up visit being to the PED rather than to another venue was significantly less for intervention than for control subjects (odds ratio, 0.88; confidence interval, 0.82-0.94), indicating decreased intensity of PED use. Conclusion: Follow-up phone calls from primary care practices after PED visits counseling patients on the use of primary care and emergency services can modulate subsequent care-seeking behavior and decrease future PED use.",
author = "Racine, {Andrew D.} and Alderman, {Elizabeth M.} and Avner, {Jeffrey R.}",
year = "2009",
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doi = "10.1001/archpediatrics.2009.45",
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T1 - Effect of telephone calls from primary care practices on follow-up visits after pediatric emergency department visits

T2 - Evidence from the Pediatric Emergency Department Links to Primary Care (PEDLPC) randomized controlled trial

AU - Racine, Andrew D.

AU - Alderman, Elizabeth M.

AU - Avner, Jeffrey R.

PY - 2009/6

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N2 - Objective: To test whether follow-up phone calls to counsel families about pediatric emergency department (PED) use and primary care availability made after an index PED visit would modify subsequent PED use. Design: Longitudinal prospective randomized intervention. Setting: An urban academic children's hospital. Patients: A total of 4246 individuals aged 0 to 21 years from each of 4 participating primary care practices recording an index PED visit from April through December 2005. Intervention: Follow-up phone call from the primary care practice within 72 hours of the initial PED visit to counsel about the availability of after-hours advice and when to access the PED. Main Outcome Measures: All subsequent visits to primary care practices, PED, pediatric subspecialists, or for inpatient hospitalization during a 365-day follow-up period. Logistic and ordinary least squares regressions estimated unadjusted and adjusted odds ratios of follow-up visits, controlling for covariates. Results: Of the 2166 intervention subjects, 816 (37.7%) recorded follow-up PED visits compared with 819 (39.4%) of the 2080 control subjects (P=.26, not significant). The adjusted odds of a follow-up visit being to the PED rather than to another venue was significantly less for intervention than for control subjects (odds ratio, 0.88; confidence interval, 0.82-0.94), indicating decreased intensity of PED use. Conclusion: Follow-up phone calls from primary care practices after PED visits counseling patients on the use of primary care and emergency services can modulate subsequent care-seeking behavior and decrease future PED use.

AB - Objective: To test whether follow-up phone calls to counsel families about pediatric emergency department (PED) use and primary care availability made after an index PED visit would modify subsequent PED use. Design: Longitudinal prospective randomized intervention. Setting: An urban academic children's hospital. Patients: A total of 4246 individuals aged 0 to 21 years from each of 4 participating primary care practices recording an index PED visit from April through December 2005. Intervention: Follow-up phone call from the primary care practice within 72 hours of the initial PED visit to counsel about the availability of after-hours advice and when to access the PED. Main Outcome Measures: All subsequent visits to primary care practices, PED, pediatric subspecialists, or for inpatient hospitalization during a 365-day follow-up period. Logistic and ordinary least squares regressions estimated unadjusted and adjusted odds ratios of follow-up visits, controlling for covariates. Results: Of the 2166 intervention subjects, 816 (37.7%) recorded follow-up PED visits compared with 819 (39.4%) of the 2080 control subjects (P=.26, not significant). The adjusted odds of a follow-up visit being to the PED rather than to another venue was significantly less for intervention than for control subjects (odds ratio, 0.88; confidence interval, 0.82-0.94), indicating decreased intensity of PED use. Conclusion: Follow-up phone calls from primary care practices after PED visits counseling patients on the use of primary care and emergency services can modulate subsequent care-seeking behavior and decrease future PED use.

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