Association of Patients' Perception of Primary Care Provider Listening With Emergency Department Use.

Introduction: This study examined whether patients' perceptions of their primary care providers' (PCP) listening frequency were associated with emergency department (ED) utilization, including a comparison to patients without PCPs.

Methods: Data were obtained from the 2015 California Health Interview Survey. Respondents were asked if they had a PCP and how often their PCPs listened, resulting in five groups: patients without a PCP (n=4,407), and patients with a PCP who perceived the PCP's listening frequency to be never (n=254), sometimes (n=1,282), usually (n=3,440), or always (n=11,651). Multiple linear regression was performed to determine if patient-perceived listening frequency of the PCP was associated with the patient's number of ED visits in the prior year, adjusting for various demographic, social, and health factors.

Results: Compared to patients without a PCP, patients with a PCP had on average 0.15 more ED visits in a year, highest among those whose PCPs were perceived as listening the least: never=0.55 more visits per year (95% CI: 0.09-1.02, =.02), sometimes=0.26 (0.01-0.51, =.04), usually=0.03 (-0.17-0.24, =.73), and always=0.16 (-0.05-0.36, =.13). Other significant increases in ED visits were associated with public insurance, African-American race, English proficiency, younger age, self-rated fair-to-poor health, asthma, and hypertension.

Conclusions: Patients who perceived their PCP as listening less frequently had more ED visits than patients whose PCPs were perceived as listening more frequently, and compared to patients without a PCP.