The Impact of Walk-in Centres and GP Co-operatives on Emergency Department Presentations

Crawford, J. et al. International Emergency Nursing | Published online: 18 April 2017

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Image source: Kake – Flickr // CC BY-NC-SA 2.0

Highlights:

  • Workload and resource pressures on EDs require the development of applicable minor illness and injury pathways.
  • Walk-in-centres have the potential to reduce ED workloads but more work is required to substantiate this pathway.
  • GP cooperatives can reduce ED workloads but further evidence is required to be confident of the efficacy of this care pathway.

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Community characteristics associated with where urgent care centers are located: a cross-sectional analysis

Sidney T Le, Renee Y Hsia. BMJ Open 2016;6:e010663.

Objectives: To determine the community characteristics associated with non-hospital-based urgent care centres wherever they are located.

Design: National cross-sectional study evaluating the association between non-hospital-based urgent care centers, and their demographic characteristics in a community, using descriptive statistics and multivariate logistic regressions.

Setting: Communities in the USA with non-hospital-based urgent care centers, as identified using a 2014 national database from the Urgent Care Association of America.

Participants: 31 022 communities encompassing 6898 urgent care centers across the USA.

Primary and secondary outcome measures: Presence of a non-hospital-based urgent care center within a community.

Results: Communities with non-hospital-based urgent care centers are urban (75.7% with vs 22.2% without; p<0.001 across rural urban commuting area levels), and are located in areas with higher income levels (38.6% in highest quartile with vs 22.3% without; p<0.001 across quartiles) and higher levels of private insurance (29.6% in highest quartile with vs 23.9% without; p<0.001 across quartiles).

Conclusions: While the growth of the urgent care industry may have other promising implications, policymakers should recognise that it may exacerbate disparities in access to acute care faced by poorer, uninsured patients, and may also have financial implications for providers that are providing overlapping services, such as emergency departments and primary care practices.

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