Within-Group Care May Reduce ED Visit Rates

TOPLINE:

Patients who visited physicians within their family practice group after normal working hours were 10% less likely to seek care at the emergency department (ED) within a week than those who visited walk-in clinics.

METHODOLOGY:

• Researchers conducted a retrospective analysis using claims data from Ontario, Canada.
• The analysis included 607,166 individuals who had within-group physician visits and 1,094,215 who visited walk-in clinics not affiliated with the practice.
• Patients in both groups were matched for similar traits. Each group included 506,033 people after matching.

TAKEAWAY:

• Patients receiving after-hours care from within-group physicians were10% less likely to seek treatment at an ED within 7 days than those visiting walk-in clinics (4.0% vs 4.4%; risk difference [RD], 0.4%; 95% CI, 0.4-0.5; relative risk [RR], 0.90; 95% CI, 0.89-0.92).
• Weekend visits to the medical group were linked to a 21% reduction in ED visits (3.7% vs 4.7%; RD, 1.0%; 95% CI, 0.9-1.1; RR, 0.79; 95% CI, 0.77-0.82).
• Children and adolescents showed the largest reduction in ED visits after seeing a within-group physician (RR, 0.87; 95% CI, 0.83-0.91), as well as residents of large urban areas (RR, 0.86; 95% CI, 0.84-0.88).
• People who visited a within-group physician were more likely to follow up with their regular family physician or another doctor from their group in the subsequent week, virtually (RR, 1.86) and in person (RR, 1.87).

IN PRACTICE:

“Compared to visiting a walk-in clinic physician, seeing a within-group physician after hours might decrease downstream emergency department visits,” the study authors wrote. “This finding could be explained by better continuity of care and can inform primary care service models and the policies that support them.”

SOURCE:

This study was led by Lauren Lapointe-Shaw, MD, PhD, of the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada. It was published online on November 25, 2024, in Annals of Family Medicine.

LIMITATIONS:

The findings might not apply broadly to all settings. The study could not investigate potential barriers related to racism due to lack of race data in the datasets. Researchers could not confirm that all within-group physicians had access to a shared electronic medical record. The decision on where to seek care was left to the discretion of patients.

DISCLOSURES:

No disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.