After-Hours Access To Primary Care Practices Linked With Lower Emergency Department Use And Less Unmet Medical Need
After-Hours Access To Primary Care Practices Linked With Lower Emergency Department Use And Less Unmet Medical Need
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DOI：
10.1377/hlthaff.2012.0494
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发表时间：
2013-01-01
期刊：
影响因子：
9.7
通讯作者：
O'Malley, Ann S.
中科院分区：
文献类型：
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作者：
O'Malley, Ann S.
《平价医疗法案》的目标之一是改善患者获得初级保健的机会以及该护理的协调。实现这一目标的一个重要因素是确保患者在正常工作时间之外获得初级保健服务。对2010年健康追踪家庭调查的分析发现，在有常规初级保健来源的人中，40.2%的人报告说，他们的做法提供了延长的时间，如在晚上或周末。分析还发现，五分之一试图在下班后与初级保健提供者联系的人报告说，联系临床医生“非常困难”或“有点困难”。那些报告在下班后联系临床医生困难较少的人，急诊室就诊次数显着减少（30.4%对37.7%），未满足医疗需求的比例较低（6.1%对13.7%），而不是经历更多困难的人。这些发现为下班后的访问提供了一个有价值的基线，特别是随着以患者为中心的医疗之家和负责任的护理组织的扩大。增加对初级保健实践的支持，以提供或协调下班后的护理，可能有助于降低急诊室的使用率和未满足的医疗需求。
One goal of the Affordable Care Act is to improve patients' access to primary care and the coordination of that care. An important ingredient in achieving that goal is ensuring that patients have access to their primary care practice outside of regular business hours. This analysis of the 2010 Health Tracking Household Survey found that among people with a usual source of primary care, 40.2 percent reported that their practice offered extended hours, such as at night or on weekends. The analysis also found that one in five people who attempted after-hours contact with their primary care provider reported it was "very difficult" or "somewhat difficult" to reach a clinician. Those who reported less difficulty contacting a clinician after hours had significantly fewer emergency department visits (30.4 percent compared to 37.7 percent) and lower rates of unmet medical need (6.1 percent compared to 13.7 percent) than people who experienced more difficulty. The findings provide a valuable baseline on after-hours access, especially as patient-centered medical homes and accountable care organizations expand. Increasing support to primary care practices to offer or coordinate after-hours care may help reduce rates of emergency department use and unmet medical need.