Enrollment with a primary care provider does not preclude ED visits for patients with woman’s health–related problems

Abstract Objective The Affordable Care Act places primary care at the cornerstone of health maintenance. It is believed that increasing access to primary health care providers will limit emergency department (ED) use. This study examines woman's health–related ED visits by patients enrolled in an obstetric/gynecologic (OB/GYN) clinic. Methods A database was created combining patient information from a hospital-affiliated OB/GYN clinic and the electronic medical records from the ED of the affiliated hospital. This database was used to evaluate woman's health–related ED use by patients registered in this OB/GYN clinic compared with patients not affiliated with the clinic. Results Over an 23-month period, there were 41,791 ED visits made by 21,223 individual women >12 years of age. A total of 7251 (17.4%) of the ED visits were for OB/GYN-related conditions. There were 6430 individual women registered at the OB/GYN clinic, 1411 (22.0%) of whom made 2415 woman's health–related visits to the ED. Of the OB/GYN-related ED visits by clinic patients, 1794 (74.3%) were made during weekdays and 1023 (42.3%) were made during hours when the clinic was open for care. Study patients had diagnostic studies beyond a urine analysis or pregnancy test performed during 61% of ED visits, with an admission rate of 2%. Conclusion Enrollment with a primary care provider alone does not eliminate the need for ED use in women with health-related conditions.