David C. Seaberg, MD, dean of the UTHSC College of Medicine, Chattanooga, will present an abstract titled, “Redirecting Low-Acuity Pediatric Emergency Department Patients to a Hospital-Based Federally Qualified Health Center.”
On June 4th, David C. Seaberg, MD, dean of the University of Tennessee Health Science Center (UTHSC) College of Medicine, Chattanooga, will present an abstract titled, “Redirecting Low-Acuity Pediatric Emergency Department Patients to a Hospital-Based Federally Qualified Health Center.” More than 600 physicians, health care clinicians and industry administrators are expected to hear his presentation during the four-day annual meeting of the Society for Academic Emergency Medicine in Phoenix, Ariz. The abstract is based on research performed at the UT College of Medicine and Erlanger Health System, Chattanooga.
In 2008, the UT College of Medicine and Erlanger Health System obtained a grant from the Center for Medicare and Medicaid Services to establish a hospital-based federally qualified health center (FQHC). These centers were created under the Public Health Service Act to provide comprehensive care to the underserved. The UT College of Medicine and Erlanger established their FQHC in clinic space adjacent to the hospital’s Pediatric Emergency Department. The FQHC was open from 6 a.m. to midnight daily and was staffed by a pediatrician. Data forms were completed on every low-acuity Pediatric Emergency Department patient during the hours of operation of the FQHC.
Through screening exams, pediatric ER patients with less severe or low-acuity conditions (emergency severity index of 4 or 5 on a scale of 10), were redirected to the FQHC. Over 12 months, 40,191 patients were signed in at Erlanger’s Pediatric Emergency Department. During this period, ER physicians and physician assistants redirected a total of 6,530 (16.2% of pediatric ER volume) to the nearby FQHC. Only three of these patients were re-triaged back to pediatric ER. The average charge per visit for the FQHC patients was $150. The majority of the clinic patients were enrolled in Medicaid.
“Our data showed that when patients and their families arrived at the hospital, they felt they were experiencing a real emergency,” observed Dr. Seaberg. “Through their health care experiences at the FQHC, they realized that emergency room care was not always required. Furthermore, 96 percent of patients and families who were redirected reported being very satisfied with their care.” He added “Interestingly, over time, 44.5 percent of the patients presenting to the FQHC had bypassed the Pediatric Emergency Department and gone directly to the FQHC clinic. That’s clear evidence that the Pediatric Emergency Department can partner with federally qualified health centers to successfully redirect patients, bypass the ER and provide quality primary care and care for minor pediatric conditions.”
The research study was funded by the Center for Medicare and Medicaid Services and by the Baroness Erlanger Foundation. Dr. Seaberg concluded that additional research is needed to examine the effect on Pediatric Emergency Department patient flow and whether patients can maintain a “medical home” at an FQHC. Other issues include negotiating with payers for a screening fee; establishing cost-effective provider contracting and staffing; improving the provider credentialing process, and reducing the cost per visit.
The mission of the Society for Academic Emergency Medicine (SAEM) is to improve patient care by advancing research and education in emergency medicine. The organization is dedicated to the improvement of care of acutely ill and injured patients by improving research and education. To achieve this mission, SAEM influences health policy through forums, publications, inter-organizational collaboration, policy development, and consultation services for physicians, teachers, researchers, and students.