The project goal is to determine the effect of freestanding emergency centers (FECs) on patients' utilization of primary health care services. The objectives are to document the characteristics and health care seeking behavior of FEC patients and to compare this information with local and national data on patients who seek care in other ambulatory settings (e.g. physicians' offices and emergency departments). FEC patient data will be collected in two phases: first, by questionnaire survey and then by medical record audit. The questionnaire survey will take place at three types of primary care sites: FECs, hospital emergency departments, and the offices of general and/or family physicians. The information gathered will include patient sex, age, ethnicity/race, education, income, length of residency, presenting complaint, fees, sources of payment, the types of primary care sites the patient has visited in the previous twelve months and the number of visits, and the rationale for choosing the site of the current visit. The medical record audit will take place in six FECs. Records of all patients seen on randomly selected days during four months of the previous year will be audited for demographic characteristics, number of visits, diagnosis, fee, and source of payment. The record audit of this larger sample of FEC patients will permit a validation of the questionnaire survey data. Study results will delineate the practice profile of a sample of FECs and document how a sample of FEC patients use primary health care services. This information is essential to determining if, and for whom, FECs are replacing or supplementing more traditional sources of care.
