BACKGROUND It has been estimated that up to one third of all emergency department (ED) visits may be "inappropriate" or non-emergent. Factors that have been speculated to be associated with non-emergent use have been noted to include low socioeconomic status, lack of access to primary care, lack of insurance, convenience of "on demand care" and the patient's individual perception of their compl...

BACKGROUND The federal government is investing approximately $20 billion in electronic health records (EHRs), in part to address escalating health care costs. However, empirical evidence that provider use of EHRs decreases health care costs is limited. OBJECTIVE To determine any association between EHRs and health care utilization. METHODS We conducted a cohort study (2008-2009) in the Huds...

This study builds a public health model of Medicaid emergency room use for 57 upstate counties in New York from 1985 to 1987. The principle explanatory variables are primary care use (based in physicians' offices, freestanding clinics, and hospital outpatient departments), the concentration of poverty, and geographic and hospital availability. These factors influence the emergency room use of a...

Physicians who provide primary care for children have a unique position to provide diagnostic, triage, educational, and preventive dental care for patients. Several papers have been published regarding primary pediatricians' participation in the preventive dental health care of their patients. One publication, a survey of physicians in Alabama focusing on physicians' overall awareness of dental...

Acute adult pharyngitis is a common reason to visit the primary care physician's office. Without knowledge of the natural course of acute pharyngitis in the adult patient, it can be easy to miss a serious complication. We offer the case of a 46 year-old man who initially presented with acute pharyngitis and eventually developed a peritonsillar abscess requiring intubation and intensive care uni...

OBJECTIVES Little research has focused on preventing harm from errors that occur in primary care. We studied mitigation of patient harm by analysing error reports from family physicians' offices. METHODS The data for this analysis come from reports of testing process errors identified by family physicians and their office staff in eight practices in the American Academy of Family Physicians N...

BACKGROUND People with disabilities report physical barriers in doctors' offices that affect the quality of care. Whether most or few doctors' offices are accessible is not known. We address this gap with data on 2389 primary care provider facilities. OBJECTIVES The analysis seeks to describe overall primary care office physical accessibility and identify (1) in which areas offices meet acces...

Introduction The Consultation and Relational Empathy (CARE) measure developed and validated in primary care settings and used for general practitioner appraisal is a 10-item instrument used by patients to assess doctors' empathy. The aim of this study is to investigate the validity of the CARE measure in assessing medical students' empathy during a formative family medicine clinical test. Metho...

BACKGROUND Family physicians are likely to care for patients that have been exposed to diseases associated with bioterrorism. Persons with seemingly nondescript initial disease symptoms could be harbingers of a larger outbreak, whether naturally occurring or purposefully created. METHODS We report a missed sentinel case of pneumonic tularemia associated with a naturally occurring outbreak. Th...