Resource utilization of adult patients referred to the emergency department from an urgent care center

ABSTRACT

Background

The rise of urgent care centers (UCC) continues to serve as an alternative to emergency departments (ED) for patients with a perceived lower acuity complaint. Patients that are deemed to be higher acuity are often evaluated at an UCC and then redirected to EDs. However, limited data exist on resource utilization by patients who are transferred from UCCs to EDs. The objective of this study was to compare resource utilization in the ED between patients who were transferred from UCCs and those who were initially evaluated in the ED.

Methods

This was a retrospective study of adult patients transferred from UCCs in Staten Island, NY to Staten Island University Hospital, between 1 March 2018 and 31 December 2018.  The first group (UCC Group) included those initially evaluated at an UCC and then referred to the ED. The second group (ED Group) included those who had their initial evaluation in the ED.

Results

572 subjects were enrolled in the UCC Group, and 84,481 in the ED Group. The UCC Group was more likely to undergo laboratory tests, plain radiographs and computed tomography, electrocardiograms, intravenous fluids, and parenteral medications. Patients in the UCC group were also more likely to be admitted to an inpatient bed or placed into ED observation (p < 0.0001). Overall, ED length of stay was longer in the UCC Group (p < 0.001).

Conclusions

Patients referred from an UCC required more ED resources and were more likely to be admitted to a hospital bed compared to those who initially self-referred to the ED.

KEYWORDS:

• Urgent care center
• emergency department
• resource utilization

Authors’ contributions

All authors were instrumental in contributing to the study concept and design, acquisition of the data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.

Availability of data and material

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Declaration of interest

The contents of the paper and the opinions expressed within are those of the authors, and it was the decision of the authors to submit the manuscript for publication.

The authors declare that they have no competing interests.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics approval and consent to participate

This study was approved by the Northwell Health institutional review board.