Only one in three patients who seek treatment in the emergency room because they don’t have a doctor are able to get an appointment with a primary care physician within a week after the visit – a follow-up that is often recommended by ER doctors, a Yale study has found.
Medicaid patients and those with back pain were even less likely to get in to see a doctor in a timely fashion – possibly because of a stigma that back pain patients are seeking opioids, the study suggests.
“For patients newly covered by Medicaid or the (state health insurance) exchange, who likely did not have a primary care physician, it’s very hard for them to get an appointment even after an ED visit,” lead author Dr. Shih-Chuan (Andrew) Chou said in a Yale news release announcing the findings, which were published in the Annals of Emergency Medicine.
The researchers hired two New Haven residents to call primary care practices in the area, and gave them a script to request appointments using various scenarios. Posing as patients with different types of insurance (traditional commercial plan, state exchange plan or Medicaid) and one of two conditions (back pain or hypertension) they made more than 600 calls to more than 50 primary care practices over eight months.
Practices offered appointments within a week only 31 percent of the time, the researchers found, with the lowest success rate for Medicaid calls, at 26 percent. Patients complaining of back pain had a harder time securing appointments than those with hypertension, with 28 percent getting appointments within a week, compared to 34 percent for the hypertension patients, the study found.
The researchers suggest emergency department and primary care physicians work together on strategies to improve the transition of care from the ED.
Natalie Missakian can be reached at news@newhavenbiz.com
