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Impact of mailing information about nonurgent care on emergency department visits by Medicaid beneficiaries enrolled in managed care.
Am J Manag Care. 1999 Dec; 5(12):1505-12.AJ

Abstract

CONTEXT

Emergency department services may be used more appropriately if laypeople's knowledge of managing minor medical problems could be enhanced, especially since Medicaid applies a "prudent layperson" standard for providing access to emergency care.

OBJECTIVE

To investigate the effect of mailing a booklet, First Look, that informed Medicaid beneficiaries about care of common nonurgent conditions and encouraged use of alternatives to emergency care including care by office-based physicians, telephonic nursing assistance, and self-care.

STUDY DESIGN

A randomized, parallel group study.

PATIENTS AND METHODS

Administrative data from 2 health plans serving urban Medicaid populations were used to identify households with a history of emergency department utilization (n = 3101 and n = 3822). Within each health plan, households were randomly assigned to receive First Look. The number of emergency department visits during 6.5 months of follow-up was the primary study endpoint.

RESULTS

Compared with controls, 1% fewer members of households that were mailed First Look visited an emergency department in each health plan (23% versus 24% in Plan A; 27% versus 28% in Plan B). The 95% confidence intervals on the observed differences were -3% to 1% and -4% to 1% in Plans A and B, respectively. The proportion of emergency department visits for conditions discussed in First Look was not significantly reduced in households that were mailed the booklet (62% versus 60% in Plan A and 51% versus 48% in Plan B).

CONCLUSION

Mailing First Look to Medicaid beneficiaries did not have a significant effect on use of emergency departments. Medicaid programs need to evaluate other, perhaps more multifaceted, interventions to promote appropriate use of emergency departments.

Authors+Show Affiliations

Center for Health Care Policy and Evaluation (MN008-W109) (TSR and PJV) and Medicaid Programs (MN012-S214) (AJL), UnitedHealth Group, Minneapolis, MN, USA. thomas_s_rector@uhc.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11066617

Citation

Rector, T S., et al. "Impact of Mailing Information About Nonurgent Care On Emergency Department Visits By Medicaid Beneficiaries Enrolled in Managed Care." The American Journal of Managed Care, vol. 5, no. 12, 1999, pp. 1505-12.
Rector TS, Venus PJ, Laine AJ. Impact of mailing information about nonurgent care on emergency department visits by Medicaid beneficiaries enrolled in managed care. Am J Manag Care. 1999;5(12):1505-12.
Rector, T. S., Venus, P. J., & Laine, A. J. (1999). Impact of mailing information about nonurgent care on emergency department visits by Medicaid beneficiaries enrolled in managed care. The American Journal of Managed Care, 5(12), 1505-12.
Rector TS, Venus PJ, Laine AJ. Impact of Mailing Information About Nonurgent Care On Emergency Department Visits By Medicaid Beneficiaries Enrolled in Managed Care. Am J Manag Care. 1999;5(12):1505-12. PubMed PMID: 11066617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of mailing information about nonurgent care on emergency department visits by Medicaid beneficiaries enrolled in managed care. AU - Rector,T S, AU - Venus,P J, AU - Laine,A J, PY - 2000/11/7/pubmed PY - 2000/11/7/medline PY - 2000/11/7/entrez SP - 1505 EP - 12 JF - The American journal of managed care JO - Am J Manag Care VL - 5 IS - 12 N2 - CONTEXT: Emergency department services may be used more appropriately if laypeople's knowledge of managing minor medical problems could be enhanced, especially since Medicaid applies a "prudent layperson" standard for providing access to emergency care. OBJECTIVE: To investigate the effect of mailing a booklet, First Look, that informed Medicaid beneficiaries about care of common nonurgent conditions and encouraged use of alternatives to emergency care including care by office-based physicians, telephonic nursing assistance, and self-care. STUDY DESIGN: A randomized, parallel group study. PATIENTS AND METHODS: Administrative data from 2 health plans serving urban Medicaid populations were used to identify households with a history of emergency department utilization (n = 3101 and n = 3822). Within each health plan, households were randomly assigned to receive First Look. The number of emergency department visits during 6.5 months of follow-up was the primary study endpoint. RESULTS: Compared with controls, 1% fewer members of households that were mailed First Look visited an emergency department in each health plan (23% versus 24% in Plan A; 27% versus 28% in Plan B). The 95% confidence intervals on the observed differences were -3% to 1% and -4% to 1% in Plans A and B, respectively. The proportion of emergency department visits for conditions discussed in First Look was not significantly reduced in households that were mailed the booklet (62% versus 60% in Plan A and 51% versus 48% in Plan B). CONCLUSION: Mailing First Look to Medicaid beneficiaries did not have a significant effect on use of emergency departments. Medicaid programs need to evaluate other, perhaps more multifaceted, interventions to promote appropriate use of emergency departments. SN - 1088-0224 UR - https://www.unboundmedicine.com/medline/citation/11066617/Impact_of_mailing_information_about_nonurgent_care_on_emergency_department_visits_by_Medicaid_beneficiaries_enrolled_in_managed_care_ L2 - https://www.ajmc.com/pubMed.php?pii=1107 DB - PRIME DP - Unbound Medicine ER -