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Is patient flow more efficient in Urgent Care Collaborations?
Elisabeth S J van Gils-van Rooij1,2, Berthold R Meijboom1, Sjoerd M Broekman3
1Scientific Center for Transformation in Care and Welfare (Tranzo), Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg.
Summary
Urgent Care Collaborations (UCCs) combining emergency departments and general practitioners do not improve patient flow efficiency. Studies show longer lengths of stay and waiting times in UCCs compared to separate services.
Area of Science:
- Health Services Research
- Emergency Medicine
- Primary Care
Background:
- Urgent Care Collaborations (UCCs) integrate emergency departments and out-of-hours general practitioner services.
- These collaborations often feature shared entrances and joint triage systems.
- The efficiency of patient flow in UCCs compared to traditional separate services is not well understood.
Purpose of the Study:
- To compare the efficiency of patient flow in Urgent Care Collaborations (UCCs) versus separately operating healthcare providers.
- To determine if integrated urgent care models enhance or hinder patient throughput.
Main Methods:
- Cross-sectional observational study design.
- Comparison of three regions with UCCs against three regions with usual care.
- Outcome measures included length of stay (LOS), waiting time (WT), and number of handovers, using electronic medical record data.
Main Results:
- Urgent Care Collaborations (UCCs) showed statistically significant longer median LOS (34:00 vs. 38:52 min) and WT (14:00 vs. 18:43 min) compared to usual care.
- Prolonged LOS and WT in UCCs were primarily attributed to general practitioner consultations.
- A higher mean number of interunit handovers was observed in UCCs.
Conclusions:
- Urgent Care Collaborations (UCCs) do not, on average, improve patient flow efficiency.
- Integrated urgent care models resulted in longer patient stays and waiting times.
- Increased handovers in UCCs suggest potential inefficiencies in care coordination.
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