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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.
Arch Pediatr Adolesc Med 2009; 163(6):505-11AP

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.

Authors+Show Affiliations

Division of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, 1621 Eastchester Ave, Bronx, NY 10461, USA. aracine@montefiore.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19487605

Citation

Racine, Andrew D., et al. "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." Archives of Pediatrics & Adolescent Medicine, vol. 163, no. 6, 2009, pp. 505-11.
Racine AD, Alderman EM, Avner JR. 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. Arch Pediatr Adolesc Med. 2009;163(6):505-11.
Racine, A. D., Alderman, E. M., & Avner, J. R. (2009). 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. Archives of Pediatrics & Adolescent Medicine, 163(6), pp. 505-11. doi:10.1001/archpediatrics.2009.45.
Racine AD, Alderman EM, Avner JR. 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. Arch Pediatr Adolesc Med. 2009;163(6):505-11. PubMed PMID: 19487605.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Racine,Andrew D, AU - Alderman,Elizabeth M, AU - Avner,Jeffrey R, PY - 2009/6/3/entrez PY - 2009/6/3/pubmed PY - 2009/6/18/medline SP - 505 EP - 11 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 163 IS - 6 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. SN - 1538-3628 UR - https://www.unboundmedicine.com/medline/citation/19487605/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_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpediatrics.2009.45 DB - PRIME DP - Unbound Medicine ER -