Evidence map›Paper›PMID 41689840›Full record

ArticleJournal of primary care & community health

Impact of Primary Care Visit Frequency on Non-Urgent Emergency Department Visits in a Large Urban Medical Center.

Akhil Chandekar, Olutola Akande, Christian Makar, Kyrillos Grace, Suha Abduselam, Omotoluwafe Balogun, Marisa Nwoke, Chika Okeke, Meron Gebreyes, Joni Ricks-Oddie and 3 more

Abstract read
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In one paragraph

Article in Journal of primary care & community health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Akhil ChandekarDepartment of Emergency Medicine, School of Medicine, University of California, Irvine, CA, USA.ORCID 0000-0002-4391-4473
Olutola AkandePRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Christian MakarPRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Kyrillos GracePRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Suha AbduselamPRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Omotoluwafe BalogunPRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Marisa NwokePRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Chika OkekePRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Meron GebreyesPRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.
Joni Ricks-OddieBiostatics, Epidemiology and Research Design Unit, Institute for Clinical and Translational Sciences, University of California, Irvine, CA, USA.
Soheil SadaatDepartment of Emergency Medicine, School of Medicine, University of California, Irvine, CA, USA.
Bharath ChakravarthyDepartment of Emergency Medicine, School of Medicine, University of California, Irvine, CA, USA.
Candice Taylor LucasPRIME Leadership Education to Advance Doctoring - African, Black and Caribbean (PRIME LEAD-ABC), School of Medicine, University of California, Irvine, CA, USA.

Funding

Institute for Clinical and Translational ScienceUM1TR004927 · NCATS · UNIVERSITY OF CALIFORNIA-IRVINE · PI DAN M COOPER, Eric J. Vilain · 2024 to 2026
$12.2M
NCATS NIH HHS UM1 TR004927
6 · The paper itself

Abstract

purposeTo examine whether primary care visit frequency (PVF) is associated with non-urgent emergency department visits (NU-EDVs) at a large urban medical center, and to identify determinants of higher PVF among Emergency Department patients.

methodsWe conducted a cross-sectional survey of adult ED patients (ESI ≥4 considered NU-EDV) at a Southern California Level I trauma center (September 2021-April 2024). Undergraduate research associates administered a 29-item instrument capturing demographics, utilization, barriers, trust in primary care, and comorbidities. Bivariate tests and multivariable logistic regression estimated adjusted odds ratios (aOR) for NU-EDV and for PVF ≥3 visits/year.

resultsAmong 964 patients with a primary care provider, 62.9% reported <3 PCP visits/year; 59.2% presented with NU-EDV. After adjustment, PVF ≥3/year was associated with lower odds of NU-EDV (aOR 0.64, 95% CI 0.48-0.87). Medicaid/Cal insurance was associated with higher odds of NU-EDV versus private insurance (aOR 1.53, 95% CI 1.12-2.08). Determinants of PVF ≥3/year included female sex (aOR 1.39, 95% CI 1.04-1.86), older age (aOR 1.01 per year, 95% CI 1.00-1.02), Black race (aOR 2.21, 95% CI 1.17-4.19), Medicaid/Cal coverage (aOR 1.70, 95% CI 1.22-2.37), more chronic conditions (aOR 1.53 per condition, 95% CI 1.35-1.71), and lower odds with PCP distrust (aOR 0.54, 95% CI 0.30-0.96).

conclusionsGreater primary care engagement is independently associated with fewer NU-EDVs; however, Medicaid beneficiaries remain at elevated risk for non-urgent ED use. Improving after-hours access, care coordination, and Medicaid-eligible unscheduled primary care may further reduce avoidable ED utilization.

Indexed as

Emergency Room VisitsEmergency Service, HospitalPrimary Health CareAccess to Primary CareAdolescentAdultAgedCaliforniaCross-Sectional StudiesFemaleHealth Services AccessibilityHospitals, UrbanHumansInsurance, HealthMaleMedicaidcare coordinationemergency department overcrowdinghealthcare access barriersnon-urgent emergency department visitspatient navigationprimary care visit frequency

Identifiers

PMID41689840
PMCPMC12906620

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.