Office "Phone First" Systems Reduce Emergency Department/Urgent Care Utilization by Medicaid-Enrolled Children.

Background: Emergency department and urgent care (ED/UC) visits for common conditions can be more expensive with less continuity than office care provided by primary care physicians.

Methods: We used quality-improvement methods to enhance telephone triage for pediatric patients by adding additional "Phone First" services including: 1) enhanced office-hours telephone triage and advice with available same-day appointments, 2) follow-up calls to parents of children self-referred to an ED/UC, and 3) parent education to telephone the office for advice prior to seeking acute care. We hypothesized that enhanced office services would reduce ED/UC utilization and cost.