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Examining Proliferation Of Urgent Care Clinics

Ruzanna Harutyunyan's picture

The Wall Street Journal on Wednesday examined how patients "who need immediate care for injuries and illness ... are increasingly turning to walk-in urgent care clinics." According to the Journal, such clinics -- which require no appointment and offer extended weekend and evening hours -- "fill the gap" between the need for care and an increasingly limited supply of primary care physicians and crowded emergency departments. In addition, care at urgent care clinics costs a "fraction" of what EDs charge, even for people with insurance, while many clinics offer additional discounts or payment plans for uninsured patients, according to the Journal.

Unlike retail health clinics, which are run by nurse practitioners, urgent care clinics are staffed by physicians and other medical personnel. In addition, many urgent care clinics have equipment, such as X-ray machines, that physicians in a traditional practice would have to refer patients to other offices or hospitals to receive.

Urgent care clinics are expanding faster than EDs, with a total of more than 8,000 clinics nationwide, allowing for more and faster patient care. Meanwhile, the number of EDs decreased from 4,176 to 3,795 between 1995 and 2005 while the number of ED visits increased by 20% to 115.3 million during that same time period, according to CDC. According to the Journal, urgent care clinics have existed for 20 years but experienced a surge in use recently as more patients encountered long waits to schedule appointments with their PCP or to receive care in an ED.

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Concerns About Quality, Safety

As the number of urgent care clinics increases, concerns have risen regarding their safety and quality, the Journal reports. In addition, there also are concerns that patients may substitute treatment at urgent care clinics for an "ongoing relationship with a primary care doctor who coordinates care and follows them over time," according to the Journal. Physicians working in urgent care clinics must be licensed but clinics often are not licensed or regulated, leading to large variances and differences between each facility. Some clinics have opted to undergo voluntary accreditation programs that evaluate their quality and safety, but there are no national standards for the facilities.

The Urgent Care Association of America recently reached an agreement with the Joint Commission to take over accreditation of these clinics and publish national quality standards by 2010. According to UCAOA Executive Director Lou Ellen Horwitz, the goal of having the commission oversee the clinics is to avoid future regulation and to establish guidelines that can help patients and insurers evaluate the clinics. She added that patients should have a PCP and seek care in urgent care clinics when they are unable to see their regular physicians (Landro, Wall Street Journal, 8/6).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.