Advantages And Disadvantages Of Urgent Care Centers

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

Despite the countless advanced in technology and the abundance of health care organization popping up all over the place, whether they are free standing clinics, hospitals, urgent cares or etc, many people still lack the ability to receive quality health care. This has become a concern throughout the world, but especially a more vocal concern for residents of the United States in the past few years. In this paper we will discuss the reasons preventing access to quality health care and how we can overcome the many obstacles that stand in our way to provide quality health care to many who lack it today.

When focusing on the Centers for Medicare and Medicaid Systems strategies for improvement with unnecessary emergency room visits, a major key area is accessibility to health care at the appropriate health care setting. For many years, there has been the perception that the emergency department is the only place for someone who is uninsured or underinsured can go to receive the needed and appropriate health care, and in some situations that may be the case. (Rhodes et al, 2013, p.394) Due to the decreases in reimbursements for the publicly funded, more and more physicians are opting out to treating these patients, thus leading to an increase in emergency department utilization. According to a study conducted by Rhodes, Bisgaier, Lawson, Soglen, Krug, and Haitsma, this is becoming a greater concern for the

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

Many uninsured and underinsured focus group participants described going to emergency departments for non‐urgent care because they could not afford to pay for private care and knew they would not have to pay the emergency department charges and/or preferred to be seen as soon as possible. Several informants mentioned that the emergency department becomes a default source of primary care, which is costly and lacks the continuity of care that chronic conditions demand ("Community Health Needs Assessment,"

Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.

Additionally, urgent care centers have been able to offer patients an alternative to the significantly higher cost of emergency room visits. Following an emergency room visit, patients are charged according to the level of care they are receiving which is rated from minor to major injuries and illnesses. Insurance companies may reject coverage of patients who sought care for a low level injury or illness in an emergency room setting leaving the patient with a large bill for a moderate condition. In addition to the cost of the treatment, insurance companies charge patients an additional fee just for utilizing an emergency room. Furthermore, the cost of seeing an urgent care provider versus an emergency department provider is significantly cheaper.

Urgent care facilities are set-up to treat minor emergencies and there is no waiting for an appointment like you would have to with your child's pediatrician. If you have one in the area, medical professionals working in a pediatric

One of the primary goals of the Affordable Care Act (ACA) was to provide affordable health care coverage and increase access to affordable health care to the community. Unfortunately, since the passage of the ACA, while there has been an increase in the number of people with health care coverage, those same people do not necessarily have access to affordable health care. Currently, the public views the Emergency Department (ED) as a safety net by the community it serves; as demonstrated by the increasing number of people who continue to seek treatment in the ED for non-urgent problems. Utilization of the ED for non-urgent care contributes to the rising costs of healthcare as treatment in this setting can be upwards of three times the cost

This will reduce the demand for ED visits and the ratio of patients with insurance to offset the cost of uncompensated care. With a decrease in demand we should see a decrease in the cost of emergency room visits as more patients get their non-emergency care at urgent care centers. The new healthcare reform will eventually reduce the burden on hospitals and insurance companies by providing the means for everyone to have healthcare and increase the ratio of insured patients seeking treatment.

Concern for the care of the patient was one of the mitigating factor for our nation’s development of Emergency medical treatment and labor act (EMTALA) . Enacted by congress in 1986, Emtala was government’s way of ensuring basic screening, stabilization and care for all patients. Non participation with emtala was not an option, since the law tied in government payments to the institutions. Simply put if you want Medicare/ Medicaid payments you will abide by this law. There shouldn’t have been need for emtala since there were already safeguards for indigent patients, but they were not followed, rather seen as guidelines. With the backing of Emtala, patients had better care assurances, and guarantee of not being dismissed. The Joint Commission on Accreditation of Hospitals stated that “individuals shall be accorded impartial access to treatment or accommodations that are available or medically indicated, regardless of race, creed, sex, nationality, or sources of payment for care” It has been strongly inferred that based on the implementation of emtala, increased numbers of uninsured were using the emergency rooms as their primary source of care. The thought was those without insurance, did not seek preventative care through a primary care doctor, as they did not have way to pay for services, but still received treatment through emergency rooms.

With so many cases of unfilled position in the hospital patients is not obtaining great services. Patient not receiving proper cares leads to closures, because of prolonged postponements that have led to deaths. Patient complaints at the emergency room have increased in recent years. Numerous patients that were admitted to the hospital’s emergency room are at high risk of dying. Six percent of emergency rooms in the U.S. have closed. These closings took place in the inner-city and low-income areas, but with an emergency room visit increasing by nearly 51%, the overwhelming amount of closures.

Urgent care clinics are for individuals seeking non-life threatening treatment. These clinics provide another level of care to the community and the intentions of urgent care are not to replace emergency

Tang N, Stein J, Hsia RY et al: Trends and characteristics and US emergency department visits, 1997 – 2007.  JAMA 2010; 304: 664-670

The emergency room has become the new primary care facility for the millions of uninsured in the United States. Thanks to an “unfunded mandate passed into law in 1986,” hospitals that participate in the Medicare program must “screen and treat anyone with an emergency medical condition” (Stephens & Ledlow, 2010). This unfortunately leads to emergency rooms full of people who may have something as simple as a sinus infection which then makes it really difficult for someone with a real emergency that did not require ambulatory transport to be seen in a timely manner. Another unfortunate result of this is that “over 1,100 emergency departments closed over the past decade” (Stephens & Ledlow, 2010).