Patients in primary care networks had fewer visits to ED, shorter stays

Patients receiving care from physicians in primary care networks were less likely to visit emergency departments, according to a new study in CMAJ (Canadian Medical Association Journal).

The study looked at data on all adults who visited 30 primary care networks in Alberta, Canada, between 2008 and 2009. There were more than 1.5 million patients who received community care from a physician in a primary care network (1709 physicians and 30 primary care networks) compared with 1.1 million in conventional care.

Patients in primary care networks were slightly older (46 v. 44 years old), had more chronic conditions and saw their doctors more frequently than those in conventional care.

Patients in a primary care network had 169 fewer visits to emergency departments for any cause and 86 fewer days in hospital because of shorter stays per 1000 patient-years.

"Our analysis suggests that a province-wide program to promote team-based primary care is a feasible and effective way to reduce use of emergency departments," writes Dr. Finlay McAlister, University of Alberta, Edmonton, Alberta, with coauthors.

Primary care networks were established in Alberta in 2005 to increase access to primary care and the Patient Medical Home care model focusing on prevention and chronic disease management.

The study shows findings similar to one from Utah, although a similar model in Ontario that includes family health teams and physician payment incentives did not show the same effect.