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Urgent Care Could Replace ED For Some Patients, Report Says

Cheryl Clark, for HealthLeaders Media, September 8, 2010

A trip to a retail clinic or urgent care center can substitute for a trip to the emergency department for between 13.7% and 27.1% of patients who don't require hospital level of care, "with a potential cost-saving of $4.4 billion annually."

That's the conclusion of a new report by Robin Weinick and colleagues from the RAND Corp. in a report published in this month's edition of the journal Health Affairs.

Use of an urgent care or a retail clinic might be a good solution for the growing shortage of office-based primary care doctors, a deficit that will only get worse as an aging physician workforce retires and as the country's population ages, requiring more acute care and pushing more patients into already crowded emergency rooms, the authors wrote.

This shortage is expected to further crowd emergency rooms with patients who can't make a timely appointment with their primary care doctor.

"A continued increase in the number of emergency department visits for nonemergency causes is likely to be unsustainable in our current healthcare system," the researchers wrote, especially as more people have health coverage under the Affordable Care Act.

But Angela Gardner, MD, president of the American College of Emergency Physicians, said in an interview Tuesday that her organization strongly disagrees with the RAND report's suggestions.

"My worry and nightmare is that patients would go to a retail clinic for a truly emergent condition, and waste valuable time. You know that emergency departments all have the equipment to treat real acute emergencies.  But all retail clinics are not created equally.

Gardner added, "They don't say at what cost all those patients could be seen in retail or urgent care clinics, the clinics aren't open in the deep of night."

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