Impact of Emergency Physician-Provided Patient Education About Alternative Care Venues

OBJECTIVES: Interventions that focus on educating patients appear to be the most effective in directing healthcare utilization to more appropriate venues. We Sought to evaluate the effects of mailed information and a brief scripted educational phone call from an emergency physician (EP) on subsequent emergency department (ED) utilizaton by low-risk adults with a recent treat-and-release ED visit. STUDY DESIGN: Patients were randomized into 3 groups for post-ED follow-up: EP phone call with mailed information, mailed information only, and no educational intervention. Each intervention group was compared with a set of matched controls. METHODS: We undertook this study in 6 EDs within an integrated healthcare delivery system. Overall, 9093 patients were identified; the final groups were the phone group (n=609), mail group (n=771), and matched control groups for each (n=1827 and n= 1542, respectively) Analysis was stratified by age (<65 and >=65years). Patients were educated about available venues of care delivery for their future medical needs. The primary outcome was the rate of 6-month ED utilization after the intervention compared with the 6-month utilization rate preceding the intervention. RESULTS: Compared with matched controls, Subsequent ED utilization decreased by 22% for patients 65 years or older in the phone group (p=.04) and by 27% for patients younger than 65 years in the mail group (p=.03). CONCLUSIONS: ED utilization subsequent to a low-acuity ED visit decreased after a brief post-ED education intervention by an EP explaining alternative venues of care for future medical needs. Response to the method of communication (phone vs mail) varied significantly by patient age.