Patients lack access to follow-up care after an ER visit, study finds

A new study finds that less than a third of patients can get a primary care appointment within a week after an ED visit if they don't have a regular primary care provider.

For patients who don't have regular primary care physicians, the odds of landing a timely follow-up appointment after a visit to the emergency room aren’t good, according to a new study. Medicaid patients face even steeper odds.

A study led by Yale University and published in the Annals of Emergency Medicine deployed a team of “secret shoppers” to call primary care practices and request appointments using scripted complaints. The shoppers posed as patients covered by varying types of insurance, seeking an appointment for either back pain or hypertension after receiving treatment in an emergency department.

The study found rates of success in obtaining an appointment date within a week of the call were much lower than those noted in prior studies, according to lead author Shih-Chuan (Andrew) Chou, M.D., a former emergency medicine resident at Yale who now works as a health policy research fellow at Brigham and Women’s Hospital.

“The most significant finding is that only a third of patients can get into primary care within a week,” said Chou in an article accompanying the study’s release.

Success rates were worst for calls on which the shoppers claimed to be insured by Medicaid, with a 26% response rate. Claims of back pain were also less likely to receive a timely appointment than claims of hypertension, a result the study’s authors note may be attributable to increased vigilance around opioid abuse.

“EDs have increasingly become the entrance to acute hospital care and the source for urgent specialty referral and care for acute illnesses,” the authors write. They suggest improved access to care will need to come from closer coordination between ERs and primary care practices.

Wait times for primary care appointments have generally been on the rise, and the presence of longer wait times for Medicaid patients aligns with data from previous studies. FierceHealthcare has previously reported that a national shortage of physicians, particularly in rural areas, has also contributed to longer wait times for new patients.