Extended Office Hours Reduce Emergency Department Use

Many parents lack access or are unaware of after-hours access to their child's doctor

TUESDAY, June 25 (HealthDay News) -- Many parents do not have access or do not know if they have access to their child's primary care doctor outside regular office hours, but extended office hours can substantially reduce the use of emergency departments, according to a study published online June 7 in The Journal of Pediatrics.

Joseph S. Zickafoose, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted an Internet-based survey of 820 parents regarding the prevalence of enhanced access services in pediatric primary care, where parents have additional options for communicating with their child's doctor, and whether these services were associated with lower use of emergency departments.

The researchers found that 80 percent of parents reported access to telephone advice during office hours, 79 percent reported same-day sick visits, and 54 percent reported telephone advice outside office hours. Only 47 percent reported access to their child's office on weekends, 23 percent reported access after 5 p.m., and 13 percent reported access by e-mail. Anywhere from 7 to 56 percent of parents reported not knowing whether these services were available. After adjusting for various factors, only office hours after 5 p.m. at least five days a week was significantly associated with use of the emergency department (adjusted incidence rate ratio, 0.51).

"The majority of parents report enhanced access to their child's primary care office during office hours, but many parents do not have access or do not know if they have access outside of regular office hours," Zickafoose and colleagues conclude. "Extended office hours may be the most effective practice change to reduce emergency department use."

The study was supported by a grant from the Blue Cross Blue Shield of Michigan Foundation, a philanthropic affiliate of Blue Cross Blue Shield of Michigan.

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