NIHCR Research Brief No. 3
Emily Carrier, Tracy Yee, Rachel A. Holzwart
While many proposed delivery system reforms encourage primary care physicians to improve care coordination, little attention has been paid to care coordination for patients treated in hospital emergency departments (EDs). As more people become insured under health reform coverage expansions, ED use likely will increase, along with the importance of better coordination between emergency and primary care physicians. This qualitative study by the Center for Studying Health System Change (HSC) examined emergency and primary care physicians’ ability—and willingness—to communicate and coordinate care, finding that haphazard communication and poor coordination often exist. This discontinuity undermines effective care through duplicative treatment and misapplied treatment. In addition, primary care physicians lose opportunities to educate their patients about when it is appropriate to use emergency departments and to learn about gaps in their own availability that may be driving unnecessary utilization by patients. Correcting these discontinuities may require a much broader commitment to interoperable information technology, investments in care coordination and malpractice liability reform than currently envisioned.
This Research Brief can be accessed at the National Institute for Health Care Reform Web site.