Parents often are not aware of available enhanced access services

Do parents know whether their pediatric provider offers enhanced access services-such as answering questions by telephone while the office is open or urgent queries after the office is closed; availability of same-day and evening sick visits; and having questions answered via e-mail? Is access to such services associated with fewer visits to an emergency department (ED)? Investigators conducted an Internet-based national survey of 820 parents to answer these questions and determine the prevalence of such enhanced access services in pediatric primary care.

Most parents reported that their child’s primary care provider offered access to advice by telephone during office hours (80%), same-day sick visits (79%), and telephone advice outside office hours (54%). Fewer than half of parents reported access to their child’s provider on weekends (47%), after 5 PM on any night (23%), or by e-mail (13%). In addition, substantial proportions of parents did not know if enhanced services were available, with 27% of parents being unaware if they could contact their child’s primary care office by phone with urgent questions outside office hours and 22% not knowing if their child could be seen in the office on the weekend. Half of parents were not aware of whether the office was ever open after 5 PM, and 57% did not know if they could use e-mail or an office website/patient portal to communicate with the office.

As to whether any enhanced services made a trip to the ED less likely, offering office hours after 5 PM on 5 or more nights a week was most consistently associated with decreased ED use (Zickafoose JS, et al. J Pediatr. 2013:163[5]:1389-1395).

COMMENTARY  Some parents will bypass their child’s medical home and head for the ED or an urgent care center even if they are aware of weekend and evening hours and access to a provider by phone or computer. But no parent who is unaware of these services will use them. If you provide any of these resources for your patients, make sure that their parents know.-Michael Burke, MD

MS FREEDMAN is a freelance medical editor and writer in New Jersey. DR BURKE, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. He is a contributing editor for Contemporary Pediatrics. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.