Coronavirus Pandemic Resulted in Unprecedented Urgent Care Utilization Changes, Study Finds

The growth of urgent care visits before the pandemic continued in 2020 and 2021, an Epic Health Research Network study shows.

The coronavirus pandemic resulted in unprecedented increases in infectious disease testing and immunizations at urgent care clinics, according to a new research article.

Urgent care visits were on an upward trend before the pandemic. The new study shows that upward trend has continued during the pandemic, with the exception of a decrease in visits early in the crisis.

The new study, which was published by Epic Health Research Network, features two key findings.

• After dropping in the first couple months of the pandemic, urgent care visits rebounded with a dramatic increase in infectious disease testing. "This increase represented a significant change in the distribution of the types of visits seen in urgent care as testing peaked at nearly 40% of urgent care visits in October 2020," the study's co-authors wrote.
   
• Immunizations helped to drive an increase in urgent care visits in 2021. "Immunization visits at urgent care are typically seen at small volumes, peaking at around 3% to 4% of visits in the late fall, likely due to the timing of influenza vaccinations. However, in 2021 immunization visits peaked at nearly 20% of urgent care visits in March of 2021, a five-fold increase from previous peaks," the study's co-authors wrote.

Interpreting the data

The decrease in urgent care utilization early in the pandemic mirrors the drop in utilization at other healthcare facilities, a co-author of the study recently told HealthLeaders.

"People were just not going to healthcare facilities at the beginning of the pandemic. In March, April, and May of 2020, people were not seeking healthcare for things that they would have done in the past. Patients were not going to their primary care offices and specialty visits. There was a drop in all access to healthcare during that time. We have seen this reflected in screening tests for mammograms, colonoscopies, and Pap smears—all of those tests decreased in the first three months of the pandemic," said Sam Butler, MD, a clinical informaticist at Epic Systems Corp.

The increase in infectious disease testing at urgent care clinics in the second half of 2020 was unprecedented, he said. "As soon as the COVID-19 test was available, it became a significant portion of urgent care clinics' business. Infectious disease testing went from a small amount of urgent care visits for things such as influenza and strep throat to close to a third of all visits. That was before there were home tests for COVID-19, and urgent care clinics were one of the few places you could get tested."

Similarly, immunization rates at urgent care clinics in 2021 reached levels never seen before, Butler said.

"In general, not just in urgent care, we have not seen an immunization be delivered to so many people in a short period of time, even though we still suffer from not enough people getting vaccinated. We vaccinated hundreds of millions of patients in the United States in a very short period. It was unprecedented to see so many immunizations at urgent care clinics. The increase in visits was not as dramatic as the testing increase, but it was significant. At its peak in 2021, immunizations were about 20% of urgent care visits," he said.

The most interesting part of the study was how urgent care was growing before the pandemic and has continued to grow except for the drop off in early 2020, Butler said. "We think that urgent care has its place, but primary care with a physician that knows you can be better care. So, we have to watch this trend. The care that we provide in urgent care needs to continue, but it does not replace the value of primary care. … Urgent care is well-suited to things such as acute injuries, but it would be less than best care for all of your care to be done at an urgent care clinic."