Bill Wang is a research assistant in the Department of Health Care Policy, Harvard Medical School, in Boston, Massachusetts.
Ateev Mehrotra is an associate professor of health care policy and medicine in the Department of Health Care Policy, Harvard Medical School.
Health Aff (Millwood). 2021 Apr;40(4):587-595. doi: 10.1377/hlthaff.2020.01869.
There is substantial interest in using urgent care centers to decrease lower-acuity emergency department (ED) visits. Using 2008-19 insurance claims and enrollment data from a national managed care plan, we examined the association within ZIP codes between changes in rates of urgent care center visits and rates of lower-acuity ED visits. We found that although the entry of urgent care deterred lower-acuity ED visits, the impact was small. We estimate that thirty-seven additional urgent care center visits were associated with a reduction of a single lower-acuity ED visit. In addition, each $1,646 lower-acuity ED visit prevented was offset by a $6,327 increase in urgent care center costs. Therefore, despite a tenfold higher price per visit for EDs compared with urgent care centers, use of the centers increased net overall spending on lower-acuity care at EDs and urgent care centers.
人们对于利用急诊护理中心来减少低紧急度急诊部(ED)就诊量有着浓厚的兴趣。利用来自全国管理式医疗计划的 2008 年至 2019 年的保险索赔和登记数据,我们在邮编分区内考察了急诊护理中心就诊率的变化与低紧急度 ED 就诊率的变化之间的关联。我们发现,尽管急诊护理中心的进入减少了低紧急度 ED 就诊量,但影响很小。我们估计,每增加 37 次急诊护理中心就诊,就会减少一次低紧急度 ED 就诊。此外,每预防一次 1646 美元的低紧急度 ED 就诊,就会导致急诊护理中心费用增加 6327 美元。因此,尽管 ED 的每次就诊费用比急诊护理中心高出十倍,但这些中心的使用增加了 ED 和急诊护理中心低紧急度护理的总支出。