Site of Treatment for Non-Urgent Conditions by Medicare Beneficiaries: Is There a Role for Urgent Care Centers?
Site of Treatment for Non-Urgent Conditions by Medicare Beneficiaries: Is There a Role for Urgent Care Centers?
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DOI：
10.1016/j.amjmed.2016.03.013
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发表时间：
2016-09-01
影响因子：
5.9
通讯作者：
Brown, Jeremiah R.
中科院分区：
文献类型：
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作者：
Corwin, Gregory S.;Parker, Devin M.;Brown, Jeremiah R.
背景：关于当无法到医生办公室就诊时，医疗保险受益人在哪里以及多久寻求非紧急情况的护理的信息有限。急诊科通常是替代护理场所，现在也出现了紧急护理中心来满足这一需求。该研究的目的是描述患有非紧急状况的医疗保险受益人的护理地点；医生办公室、紧急护理中心和急诊室利用之间的关系；方法：本研究是对 2012 财年按服务收费的 Medicare 受益人进行的一项回顾性横断面研究。主要结果是紧急护理中心、急诊科或医生办公室利用率和地理差异。结果：非紧急情况的护理最常发生在医生办公室（每 100 名受益人中有 65.0 人）。相比之下，紧急护理中心（每 100 名受益人 6.0 名）比急诊科（每 100 名受益人 1.0 名）更常见。总体而言，83% 的非紧急就诊是医生办公室，14% 是紧急护理中心，3% 是急诊科。紧急护理中心、急诊科和医生办公室对非紧急情况的利用情况存在地区差异。急诊科利用率较高的区域对应于紧急护理中心和医生办公室利用率较低的区域，而紧急护理中心利用率较高的区域的急诊科利用率较低。结论：紧急护理中心是医疗保险受益人非紧急情况的重要护理场所。紧急护理中心、急诊科和医生办公室的使用情况存在地区差异，紧急护理中心利用率较低的地区急诊科利用率较高。利用紧急护理中心治疗非紧急情况可能会减少急诊室的利用率。由爱思唯尔公司出版
BACKGROUND: There is limited information on where and how often Medicare beneficiaries seek care for non-urgent conditions when a physician office visit is not available. Emergency departments are often an alternative site of care, and urgent care centers have now also emerged to fill this need. The purpose of the study was to characterize the site of care for Medicare beneficiaries with non-urgent conditions; the relationship between physician office, urgent care center, and emergency department utilization; and specifically the role of urgent care centers.METHODS: The study is a retrospective, cross-sectional study of fee-for-service Medicare beneficiaries for fiscal year 2012. The main outcome was rate and geographic variation of urgent care center, emergency department, or physician office utilization.RESULTS: Care for non-urgent conditions most commonly occurred in physician offices (65.0 per 100 beneficiaries). In contrast, urgent care centers (6.0 per 100 beneficiaries) were a more common site of care than emergency departments (1.0 per 100 beneficiaries). Overall, 83% of non-urgent visits were physician offices, 14% urgent care centers, and 3% emergency departments. There was regional variation in urgent care center, emergency department, and physician office utilization for non-urgent conditions. Areas of higher emergency department utilization correspond to areas of lower urgent care center and physician office utilization, whereas areas of higher urgent care center utilization had lower emergency department utilization.CONCLUSIONS: Urgent care centers are an important site of care for Medicare beneficiaries for non-urgent conditions. There is regional variation in the use of urgent care centers, emergency departments, and physician offices, with areas of low urgent care center utilization having higher emergency department utilization. The utilization of urgent care centers for treatment for non-urgent conditions may decrease emergency department utilization. Published by Elsevier Inc.