Hospital-affiliated pediatric urgent care clinics: a necessary extension for emergency departments?
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.
Tennyson
Debra H
DH
Political Science Department, Division of Health Administration, Auburn University, 7096 Haley Center, Auburn, AL 36849, USA.
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D039602:After-Hours Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007350:Insurance, Hospitalization / Q000706:statistics & numerical data; D008297:Male; D009935:Organizational Affiliation; D014481:United States; D014600:Utilization Review