Urgent care centers (UCCs) are a convenient and faster alternative to emergency departments (EDs) for low-acuity acute treatment, but little is known about the quality of care at UCCs. For a study, researchers compared the characteristics of patients referred to the ED by UCC doctors (provider-referred) to those of patients who went to the ED on their own (self-referred) within 72 hours after discharge from a UCC visit. The major goal was to see if there were any differences in the usage of observation units or hospital admission rates between the two groups. Their secondary goal was to determine if their subsequent ED visits might have been avoided.
They conducted this prospective cohort research in a closed health system between March 22, 2017, and September 30, 2018. There were 582 provider-referred and 263 self-referred ED visits among the 53,178 UCC visits. They compared the two groups’ characteristics and assessed the results of observation unit or hospital admissions.
Patients who self-referred to the ED were younger; the mean (standard deviation) age was 47.9 (24.5). Patients referred by providers seemed to be substantially linked with observation unit or hospital admission (odds ratio [OR] 1.75; 95% CI 1.24-2.46). Consultation with a specialist in the ED was the largest predictor of observation unit or hospital admission (adjusted OR 9.09; 95% CI 6.24-13.24); other significant predictors were Medicaid or no insurance.
They found that after an urgent care visit, patients who were sent to the ED by a UCC provider were not more likely than self-referred patients to be admitted to an observation unit or hospital from the ED. Special consultation and type of insurance were significant predictors for observation unit or hospital admission after UCC discharge.
Reference: jem-journal.com/article/S0736-4679(22)00054-3/fulltext
