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Purpose: Urgent Care (UC) currently represents a heterogeneous population of clinic sites with varying staffing and care models. The goal of the study was to explore factors associated with patient length of stay (LOS) and disposition of transfer.
Background/Significance: Urgent Care centers are one of the fastest growing venues of health care delivery. Due to the share of pediatric patients seen in UC, there has been a growth of specialized pediatric UC centers. Pediatric UC centers have not been studied in terms of practice variation or patient outcomes because there is no centralized database to study these patients. To define common administrative practices of pediatric urgent care: staffing, scope of practice, and ancillary services as well as clinical measures such as patient throughput, disposition of transfer, and length of stay.
Methods: This is a cross-sectional national survey of pediatric urgent care sites. Contributing sites were recruited from national professional organizations of pediatric urgent care providers. The online survey was administered and collated into a REDCap database. Counts and frequencies were used to analyze the categorical data. Continuous data were described with median and interquartile ranges. Non-parametric distributions in LOS, transfer rates, and throughput were compared using Mann-Whitney U tests and Spearman’s correlation was used to describe dependency of variables.
Results: From emailed invitations, 125 of the 188 sites (66%) completed the survey. Slightly more than half (55.2%) were associated with a hospital system; whereas, the other 44.8% were privately owned. The median annual patient volume was 12594 [7719, 20664] and length of stay was 56 minutes [48, 73]. There was a correlation (r=.28, p=0.01) of increasing volume with increasing LOS, although this may not be clinically significant. There was no correlation (r=0.12, p=0.31) between LOS and throughput (patients per provider per hour). Median transfer rate was 1.6% [1-3.9%]; however, there was significant difference in transfer rates between hospital based (2.8%) and privately owned (0.7%) pediatric urgent care centers.
Conclusions: Increasing expertise and scope of care was correlated with decreased LOS. Transfers were less likely in a privately owned pediatric urgent care, but overall were positively associated with increasing LOS. Future studies on clinical outcomes and quality of care in relation to LOS and transfer rates are needed.
Cohen, Meghan; Lee, Brian; and Montalbano, Amanda, "Factors Associated with Length of Stay and Transfer Rates in the Pediatric Urgent Care Setting: 2017 OUCH Data" (2019). Research at Children's Mercy Month 2019. 16.