Urgent care

Urgent care is a category of walk-in clinic focused on the delivery of ambulatory care in a dedicated medical facility outside of a traditional emergency room. Urgent care centers primarily treat injuries or illnesses requiring immediate care, but not serious enough to require an ER visit. Urgent care centers are distinguished from similar ambulatory healthcare centers such as emergency departments and convenient care clinics by their scope of conditions treated and available facilities on-site. While urgent care centers are usually not open 24-hours a day, 70% of centers in the United States open by 8:00 am or earlier and 95% close after 7:00 pm.

The initial urgent care centers opened in the 1970s. Since then, this healthcare industry sector rapidly expanded to approximately 10,000 centers. Many centers were started by emergency medicine physicians, responding to a public need for convenient access to unscheduled medical care. A significant factor for the increase of these centers is significant monetary savings when compared to ERs. Many managed care organizations (MCOs) now encourage or even require customers to utilize urgent care options. As of 2014, the urgent care industry is worth an estimated $14.5 Billion.

In 2014, US communities with non-hospital-based urgent care centers (UCCs) were mainly urban, located in areas with higher income levels and higher levels of private insurance. Kaissi et al considered local multi-hospital systems in Florida, Maryland, Nevada, Texas, Virginia and Washington. In 2012 50% of 117 hospital-based "clusters" included either UCCs, retail clinics, or both. 57% of systems in Washington operated an UCC, compared to 36% of systems in Washington, while systems in Florida had the largest share of UCCs (17.6%). Authors noted unexplained state-by-state variation in hospital system partnership with UCC and retail clinic models. Corwin et al considered Medicare beneficiaries presenting to an UCC (n=1,426,354) emergency department (ED) (n=334,841) or physicians office (n=8,359,498) with upper respiratory or urinary tract infections, bronchitis, sprains or contusions, and back or arthritic pain, in 2012. Patients who presented to an ED were more likely to be female (67% of ED presentations) compared to those who presented to a UCC or physicians office (65% and 64% respectively). Patients who presented to an UCC were significantly more likely to be aged over 85 (27%, compared to 15% of physicians office presentations, and 13% of ED presentations) or Black (11%, compared to 6% of physicians office presentations, and 4% of ED presentations). In 2014, 3.1% of Family Physicians in the United States worked primarily in UCCs, with a male:female ratio of workforce is 6:7, and an urban:rural ratio of 2:1. This compares to 3.6% of Family Physicians working primarily in Emergency Care, with a male:female ratio of 5:3 and urban:rural ratio approaching 1:2.

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