Parent Motivations - Urgent Care vs Hospital

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Parent Motivations - Urgent Care vs Hospital

Additional motivations of parents of children under the age of 18 for choosing urgent care facilities over emergency rooms are high deductibles, convenience, and wait times. Although urgent care centers have grown significantly since 2013 and have taken patients from emergency rooms, they have not taken as much revenue due to price hikes on emergency room visits. More details are below.

High Deductible Health Insurance

  • As health insurance has become more unaffordable in the United States, consumers have had to purchase plans with high deductibles to keep their monthly premiums as low as possible.
  • High deductibles mean that people have to pay more out-of-pocket before their insurance contributes to healthcare costs. As a result, people will often choose the cheaper option for urgent care needs.
  • Studies show that emergency room visits cost about ten times as much as urgent care visits for the same diagnoses and treatments.
  • Therefore, people with high deductibles may choose urgent care facilities to save money if they have not yet met their deductible.
  • Additionally, for consumers who do not have high deductibles, insurers are increasingly requiring higher copays for emergency care as well, so even if there is no high deductible involved, people are still choosing urgent care because "insurers typically do cover urgent care and walk-in clinics, with copays similar to what [one] would pay at [their] doctor’s office."

Convenience

  • Convenience is another reason parents may choose an urgent care facility over an emergency room.
  • There are approximately 3,000 fewer emergency rooms in the U.S. than there are urgent care centers, which means there is more likely to be an urgent care facility near a person's home than an emergency room.
  • Dr. Sabrina Poon, co-author of the study, "Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions in the United States From 2008 to 2015," indicated that a main driver of urgent care visits is convenience.
  • Ateev Mehrotra, MD, an associate professor of health care policy and medicine at Harvard Medical School, agrees with Dr. Poon, saying, "When we talk to patients [about why they choose urgent care] they say the number one, number two and number three reasons are convenience... That implies that the existing care options are a royal pain."
  • Additionally, the " increasing number of clinics" was given as a probable reason behind the increase in urgent care visits between 2008 and 2015.
  • A survey conducted by Solv found that 14% of people who visited urgent care centers would have gone to the emergency room if access to a more convenient urgent care was not available.
  • Patients can often find it difficult to get a timely appointment with their primary care physician and are instead choosing to visit urgent care facilities instead, where they can be seen without an appointment.
  • Nearly 77% of all urgent care facilities are within a mile from a pharmacy and 20.3% are within a mile of a major hospital.

Wait Time

  • Parents with children under the age of 18 also often choose urgent care over emergency care because wait times to see a doctor are usually shorter.
  • A 2018 study by UCA found that over 70% of patients waited less than 20 minutes for a doctor at urgent care centers and 94% were seen in less than 30 minutes.
  • Overall, 85% of patients who go to urgent care facilities are seen in under an hour.
  • Another study of urgent care centers found that "no urgent care provider had a line of patients above four at a time."
  • Conversely, the average emergency room patient waits more than a half an hour to be seen by a provider and 2.25 hours to be discharged.
  • One mother said, "I do find myself using (urgent cares) more frequently just because I can get right in and still pay the same amount."
  • Emergency rooms have to triage patients based on the severity of their injury or illness, meaning patients with less severe needs will wait longer. Urgent care facilities do not treat the most severely emergent patients, so there is usually no need to triage patients.

Growth of Urgent Care Centers

  • In 2013, there were 6,100 urgent care centers in the United States.
  • By November 2018, there were 8,774 urgent care centers in the United States, which was an increase of 8% over the 8,125 in 2017 and a 44% increase over 2013.
  • In 2015, the latest year for which there is data, there were only 5,564 hospitals in the U.S., some of which do not have emergency rooms. This is a decrease of 30% since 1970.
  • Between January 2008 and December 2015, visits to emergency rooms for "low-acuity conditions" decreased by 36%, while the use of urgent care facilities increased by 119%.
  • Emergency room revenue has not been impacted by this growth, however, because of a "79% increase in price per emergency room visit for treatment of low-acuity conditions."
  • Overall, emergency room prices increased by 85% between 2008 and 2015, which offset the revenue lost to urgent care centers.
  • However, small hospitals in rural areas say "that for-profit urgent care centers threaten their revenue streams, making it more difficult for them to continue to provide lower-revenue services such as obstetrics, mental health care and addiction treatment."
  • Health systems are currently considering partnerships with urgent care centers to enhance their brand and to create a new stream of revenue.
  • Additionally, some hospitals are beginning to operate their own urgent care clinics to meet customer demand and keep revenues steady.

Research Strategy

To avoid duplicating the information provided in earlier research, we had to expand our search to include motivations of all people for choosing either urgent care centers or emergency rooms. We discovered that the main reasons why people in general choose emergency rooms were already provided in that earlier research. There were several unmentioned reasons why people choose urgent care facilities in our continued research, so we provided that information here. We additionally assumed that parents would have similar reasons as the overall population for choosing urgent care centers over emergency rooms.
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