Urgent Care Center and Emergency Department Utilization for Non-Emergent Health Conditions: Analysis of Managed Care Beneficiaries.

Abstract

The objective was to identify predictors of utilization for urgent care centers (UCCs), emergency departments (EDs), or for both services for non-emergent health conditions among beneficiaries from a managed care organization (MCO) who resided within a 10-mile radius of UCCs. A cross-sectional design was used to analyze 2016 administrative claims data from an MCO that contracted with a UCC with 12 locations (n = 20,107). Outcome variables were number of visits to UCC, ED, or both. The MCO used the New York University ED algorithm to identify non-emergent health conditions. The Behavioral Model of Health Care Utilization was used as a conceptual framework to identify predictors in the model; age, sex, race/ethnicity, distance to UCC from residence, type of insurance, primary care physician visits, inpatient admissions, chronic conditions, morbid obesity, and smoking behavior. Generalized linear models were used to analyze the association between outcomes and predictors. About 22.7% were UCC users, 66.8% were ED users, and 10.5% used both. African Americans (incident rate ratio [IRR] = 0.95; 95% confidence interval [CI]: 0.91-0.98] were less likely to use UCCs and more likely to use the ED (IRR = 1.10; 95% CI: 1.07-1.13). Beneficiaries with multiple chronic conditions were more likely to use the ED than UCCs. Distance was not a predictor of UCC or ED usage. Utilization of UCC was low for non-emergent health conditions. African Americans and individuals with multiple chronic conditions preferred the ED to UCC for non-emergent health conditions. This study implies that MCO beneficiaries, especially the African American population, need to be informed about UCC locations and services provided.