Primary Care Interactions and ER Use by Safety Net Hispanic Patients in the United States.

Abstract

Reducing inappropriate emergency room (ER) visits is a major health management objective. While Hispanic patients reportedly have the highest percentage of avoidable ER visits (4.89%), empirical research is scarce. Effective provider communication can increase appropriate ER utilization. Our objective was to examine associations between safety net primary care providers' communication with Hispanic patients and Hispanic patients' ER use. We used 2022 Health Center Patient Survey data collected by the United States Health Resources and Services Administration. Our predictors were patient-reported provider communication and nonclinical staff evaluation items from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) instrument. Our outcome variable was patient-reported ER visits in the previous year. We used binary logistic regression to examine the association. Patients who had used health centers longer had significantly lower odds of ER visits (44%-46%). Patients who had initiated conversations about their health issues had 55% higher odds of ER visits. Healthier patients and women had lower odds while insured patients and those with frequent visits to health centers had higher odds of ER use. Primary care continuity, stable medical home, and effective interactions with providers may reduce ER use.