Abstract
The traditional model of primary care practices as the main provider of care for acute illnesses is rapidly changing. Over the past two decades the growth in emergency department (ED) visits has spurred efforts to reduce “inappropriate” ED use. We examined a nationally representative sample of office and ED visits in the period 2002-15. We found a 12 percent increase in ED use (from 385 to 430 visits per 1,000 population), which was dwarfed by a decrease of nearly one-third in the rate of acute care visits to primary care practices (from 938 to 637 visits per 1,000 population). The decrease in primary care acute visits was also present among two vulnerable populations: Medicaid beneficiaries and adults ages sixty-five and older, either in Medicare or privately insured. As acute care delivery shifts away from primary care practices, there is a growing need for integration and coordination across an increasingly diverse spectrum of venues where patients seek care for acute illnesses.
Original language | English (US) |
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Pages (from-to) | 268-275 |
Number of pages | 8 |
Journal | Health Affairs |
Volume | 38 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2019 |
Funding
Arjun Venkatesh reports career development support from the National Center for Advancing Translational Sciences (Grant No. KL2TR001862) and the Yale Center for Clinical Investigation. Seth Trueger received stipends as social media editor for Annals of Emergency Medicine and Emergency Physicians Monthly. He also became digital media editor for JAMA Network Open on July 1, 2018. Arjun Venkatesh reports career development support from the National Center for Advancing Translational Sciences (Grant No. KL2TR001862) and the Yale Center for Clinical Investigation. Seth Trueger received stipends as social media editor for Annals of Emergency Medicine and
ASJC Scopus subject areas
- Health Policy