B H Warren1, S J Isikoff. 1. Department of Internal Medicine, College of Medicine, University of Arizona Health Sciences Center, Tucson.
Abstract
OBJECTIVE: To identify the most cost-effective utilization of resources for urgent care for a managed care Medicaid population at a university medical center. The null hypothesis was that there are no significant differences between the costs and types of services for patients with comparable urgent care problems who are seen in outpatient clinical settings compared with those seen in the central emergency department of a university medical center. DESIGN: Retrospective case study comparing patient visits and charges for three clinical urgent care locales by diagnosis, severity of illness, age group, time period in which seen, and reason for referral. SETTING: Ambulatory care and hospital emergency department facilities at a university medical center. PATIENTS: 1096 Medicaid patients who were enrolled in the university physicians' managed care plan. MAIN OUTCOME MEASURES: Diagnosis-specific comparisons of types of services and charges for patient visits. RESULTS: There were significantly higher charges for all urgent care diagnoses of patients treated in the emergency department compared with urgent care facilities; these costs were higher in all categories of charges. CONCLUSIONS: A variety of alternatives to use of the full emergency department are more cost-effective in providing urgent care services for Medicaid clients in a managed care setting.
OBJECTIVE: To identify the most cost-effective utilization of resources for urgent care for a managed care Medicaid population at a university medical center. The null hypothesis was that there are no significant differences between the costs and types of services for patients with comparable urgent care problems who are seen in outpatient clinical settings compared with those seen in the central emergency department of a university medical center. DESIGN: Retrospective case study comparing patient visits and charges for three clinical urgent care locales by diagnosis, severity of illness, age group, time period in which seen, and reason for referral. SETTING: Ambulatory care and hospital emergency department facilities at a university medical center. PATIENTS: 1096 Medicaid patients who were enrolled in the university physicians' managed care plan. MAIN OUTCOME MEASURES: Diagnosis-specific comparisons of types of services and charges for patient visits. RESULTS: There were significantly higher charges for all urgent care diagnoses of patients treated in the emergency department compared with urgent care facilities; these costs were higher in all categories of charges. CONCLUSIONS: A variety of alternatives to use of the full emergency department are more cost-effective in providing urgent care services for Medicaid clients in a managed care setting.