Le Sidney T, Hsia Renee Y
School of Medicine, University of California at San Francisco, San Francisco, California, USA.
Department of Emergency Medicine, Philip R. Lee Institute for Health Policy Studies, University of California at San Francisco, San Francisco, California, USA.
BMJ Open. 2016 Apr 7;6(4):e010663. doi: 10.1136/bmjopen-2015-010663.
To determine the community characteristics associated with non-hospital-based urgent care centres wherever they are located.
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.
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.
31,022 communities encompassing 6898 urgent care centers across the USA.
Presence of a non-hospital-based urgent care center within a community.
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).
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.
确定无论位于何处的非医院型紧急护理中心所具有的社区特征。
全国性横断面研究，运用描述性统计和多变量逻辑回归评估非医院型紧急护理中心与其所在社区人口特征之间的关联。
利用美国紧急护理协会2014年的全国数据库确定的美国设有非医院型紧急护理中心的社区。
涵盖美国6898家紧急护理中心的31022个社区。
社区内非医院型紧急护理中心的存在情况。
设有非医院型紧急护理中心的社区为城市社区（有该中心的占75.7%，无该中心的占22.2%；在城乡通勤区各层级中p<0.001），且位于收入水平较高（最高四分位数中有该中心的占38.6%，无该中心的占22.3%；在各四分位数中p<0.001）和私人保险水平较高（最高四分位数中有该中心的占29.6%，无该中心的占23.9%；在各四分位数中p<0.001）的地区。
虽然紧急护理行业的发展可能有其他积极影响，但政策制定者应认识到，这可能会加剧贫困、未参保患者在获得急性护理方面面临的差距，并且可能会给提供重叠服务的医疗机构（如急诊科和初级保健机构）带来财务影响。
