Hospital-Affiliated Pediatric Urgent Care Clinics

Abstract

This study analyzed whether a children's hospital urgent care clinic helped increase market share. Patient demographics and utilization patterns between the suburban clinic and urban emergency department were compared over a three-year period (July 1999 to June 2002). Using data from a standardized billing form, all patient visits (clinic: 36,924; emergency department: 160,888) were analyzed. Variables included patient visitation date, age, gender, race, primary insurance carrier, primary diagnosis, and primary residence Zip code. Differences between the after-hours clinic and emergency department included: more private insurance coverage (83% and 35%, respectively); less no insurance/Medicaid/State Children's Health Insurance Program (SCHIP) coverage (16.4% and 55%, respectively); and more Caucasian patients (80% and 35%, respectively) at the off-site clinic; thus usage was more similar with that of a physician's office than an outpatient clinic. Symptoms seen in the after-hours clinic were primarily respiratory, ear, and throat related. In the emergency department, the symptoms were more varied, primarily febrile, respiratory, ear, throat, gastrointestinal, and urinary tract problems. There was a 3.6% increase in the number of visits in the after-hours clinic and a 1.6% decrease in the number of emergency department visits between year one and year three--data combined giving an overall 4.8% increase in the number of visits. Data show that the offsite urgent care clinic located in a suburban area increased the overall number of visits with a large number of well-insured patients. Additionally, this study provided data on where the clinic could expand medical care for the community.

Transfers From a Pediatric Urgent Care to an Academic Pediatric Emergency Department

“…4 In some areas, urgent care centers specializing in pediatrics have opened, some of which are affiliated with a children's hospital. 5 A previous study done at our institution evaluated the clinical appropriateness of transfers from general urgent care centers into our pediatric ED. 6 That study showed that a significant proportion of transfers were discharged home with minimal ED resource utilization, suggesting that those transfers were not necessary.…”

“…A 2009 survey of approximately 500 urgent care centers found that only 9.6% had a pediatrician on staff, none of whom were full-time 4 . In some areas, urgent care centers specializing in pediatrics have opened, some of which are affiliated with a children’s hospital 5 …”