P3B213: Follow-up with a Primary Care Provider After an Emergency Department (ED) Visit in Pediatrics: A Narrative Review

Background: Most children seeking emergency care present to the general Emergency Department (ED); appropriate follow-up is essential to ensure continuity of care. This is especially true in a resource-limited community setting. Follow-up visits after ED discharge decrease stress amongst patients and their families through better communication and understanding and increase awareness about their health and management. Data suggests that they also help reduce the likelihood of future ED visits. A unique set of challenges accompanies pediatric ED and Primary Care Provider (PCP) visits and require a specifically catered approach when developing emergency services, training ED staff, stocking equipment and medication and planning for a follow-up. We aimed to analyze existing literature focused on follow-up with a PCP after an ED visit to propose a new framework to fill existing gaps and accommodate unique needs.

Methods: We conducted a PubMed search using the following keywords: follow-up, primary care, and emergency department/ED. We included seven studies that focused on pediatric ED visits. We analyzed the results of each study, varying from the risk of recurrent ED visits, patient responses to follow-up reminders, interlinking ED and PCP visits, and the impact of follow-up appointments on management, patient comfort, and clinical outcomes.

Results: We summarized the results in the table below and created a hypothetical framework for follow-up visits.

Conclusion: More communication between providers and ED doctors may improve clinical outcomes. The need for follow-up after an ED visit depends on various factors, such as a history of past ED visits, patient diagnoses, and the need for changes in interventions. We suggest using a generalized framework in a community healthcare setting to ensure follow-up, timely changes in management and continuity of care, improve health literacy, and prevent recurrent ED visits.