Emergency Room Use in the Healthy Beginnings Program

Faculty Mentor(s)

Dr. Sonja Trent-Brown, Hope College
Professor Vicki Voskuil, Hope College

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The Ready For School Healthy Beginnings project aims to increase access to healthcare by establishing a medical home for all children ages birth through five in regional opportunity zones. The intervention program at two pilot sites utilizes a case manager (RN) and a community health worker to increase access to medical care for at risk children. Participants in the Healthy Beginnings program numbered 1375 children between the ages of 0-5. Emergency room (ER) visits, urgent care facility visits and hospital inpatient admissions were tracked across the children to determine the patterns of use with respect to time of day and diagnosis. Data were accessed from reports generated by the local hospitals and urgent care sites. Results showed that for program participants who used the emergency room those visits often occurred between the hours of 8 a.m. and 5 p.m. during the hours of operation of the child’s medical home. Additionally, some of the emergency room visits occurred between 5 p.m. and 8 p.m. during extended clinic hours for the patients’ medical home. Of the indicated diagnoses, there was evidence that some of the participants used the ER as a primary healthcare facility. The most common emergency room diagnoses included respiratory and gastrointestinal maladies. The results from baseline data indicate areas of parental education are needed in order to decrease overuse of the emergency room. Parent education should include orientation to clinic hours to limit ER use when the medical home is open, ensuring that parents know when an ER visit is necessary versus going to the medical home in order to limit diagnoses such as “well-child” and “unspecified” and should emphasize the importance of calling the medical home prior to an ER visit in order to determine whether the clinic can serve the patient’s needs.


This research is supported by the Kellogg Foundation and the Hope College-Howard Hughes Medical Institute Faculty Department for Interdisciplinary Research.

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