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Capstone Committee Chair: Mona Sarfaty, MD, MPH, Jefferson Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.


Patients who go to the emergency department (ED) for non-emergent care instead of a primary care practice can cause overcrowding of the ED, which can lead to decreased quality of care and increased medical costs (Trzeciak, S. & Rivers, E., 2003). Previous studies have shown that primary care practices have characteristics that may affect how patients utilize the ED (National Quality Forum, 2010). The purpose of this study was to identify ED utilization by Jefferson Family Medicine Associates’ (JFMA) patients for non-emergent/ambulatory care sensitive conditions, analyze patients’ reasons for using the ED rather than JFMA for these conditions, and assess patients’ awareness of JFMA hours of operation and other services available to reduce ED misuse. Telephone interviews were conducted and demographic information was collected from patients who went to the ED for non-emergent care. Results showed that most patients went to the ED on Monday (20.3%), and 10AM (8.5%) was the most common time throughout the week. Barriers to patient utilization of JFMA included difficulty booking an appointment (26.7%), long waits in the waiting room (10%), lack of insurance (10%), costs of copays (10%), and housing difficulties (6.7%). The majority of patients interviewed were unaware of the practice hours (80%). These findings suggest quality improvement interventions can address barriers to primary care in order to decrease misuse of the ED.

Presentation: 22 minutes