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Presentation to Either the Pediatric Emergency Department or Primary Care Clinic for Acute Illness: The Caregivers’ Perspective

Nokoff, Natalie MD*; Brunner, Andrew M. MD; Linakis, James G. MD, PhD; Amanullah, Siraj MD, MPH

doi: 10.1097/PEC.0000000000000082
Original Articles

Objectives This study aimed to understand and compare caregivers’ perceptions of and attitudes toward care received in a primary care clinic (PCC) versus that received in the pediatric emergency department (PED) as well as the reasons for selecting either location to receive care for their child.

Methods Surveys were administered to caregivers of children who receive their primary care at the same location who presented for a nonurgent sick visit to either the PCC or PED during regular PCC hours.

Results One hundred fifty-one caregivers in the PCC and 83 in the PED completed the survey. Compared with caregivers who brought their child to the PED, those who presented to the PCC were more likely to report that the child had been sick for more than 2 days (P < 0.001), indicate that the child could wait more than 3 hours to be seen (P < 0.001), have called the PCC for advice (odds ratio [OR], 5.2; 95% confidence interval [CI], 2.9–9.2), have spoken with a nurse (OR, 3.7; 95% CI, 2.0–6.7), be satisfied with their phone call to the PCC (OR, 12.2; 95% CI, 6.4–23.1), and report that they could easily get in touch with the PCC (OR, 3.6; 95% CI, 1.8–7.3). Most caregivers who went to the PCC felt that it was more convenient (98.6%) and they would be seen more quickly (95.8%).

Conclusions Although all children had the same medical home, caregivers who presented to the PCC were more likely to have called the clinic, spoken with a nurse, and reported greater satisfaction with the PCC than those who brought their child to the PED.

From the *Department of Pediatrics, University of Colorado, Denver, CO; †Department of Internal Medicine, Harvard University, Boston, MA; and ‡Departments of Emergency Medicine and Pediatrics, The Warren Alpert Medical School, Brown University, Section of Pediatric Emergency Medicine, Hasbro Children’s Hospital, Providence, RI.

Disclosure: The authors declare no conflict of interest.

Reprints: Natalie Nokoff, MD, 13123 E 16th Ave, Box 158, Aurora, CO 80045 (e-mail:

The funding for this project was made possible through the generous support of the Amgen Foundation.

© 2014 Lippincott Williams & Wilkins, Inc.