Project Description Narrative:
According to the Wisconsin Hospital Association, approximately 30% of all emergency department (ED) visits by uninsured and underinsured patients in selected Milwaukee hospitals were deemed non-emergent in 2006. Many low-income individuals use the ED for primary care purposes because they do not have access to a primary care "medical home." Those with chronic health conditions such as high blood pressure, diabetes, asthma, and mental health issues may have multiple ED encounters in a single year, and some seek care at several different emergency department for the same conditions. The use of the ED for primary care services results in episodic care, which is costly and results in poor health care outcomes as it does not afford continuity of patient care or appropriate disease management for people with chronic medical or behavioral health conditions.
According to surveys of ED staff and patient focus groups, many factors influence why, when, and where a patient seeks ED services over primary care, including the patient's perception of the seriousness of their condition, transportation oprtions, perceptions about the quality of non-emergency care settings, the time it takes to secure a primary care appointment, as well as their insurance status. To improve health outcomes and reduce costs, diverting non-emergent patients from EDs and linking them to primary medical homes is a key strategy.
Through this award, project partners will develop, implement, and evaluate an ED to Primary Care Medical Home Referral and Retention Project, aiming to divert uninsured and underinsured non-emergent patients from EDs and connect them with primary care medical homes to improve their access to quality, consistent health care.
Additional community partners: Health Care for the Homeless of Milwaukee, Inc.; Milwaukee Health Services, Inc.; Westside Healthcare Association, Inc.
Additional MCW academic partner: Marie Wolff, PhD, Family and Community Medicine