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Longitudinal Urgent Care Psychiatry as a Unique Access Point for Underserved Patients
David S Kroll1, Karen Wrenn1, John A Grimaldi1
1Department of Psychiatry, Brigham and Women's Hospital, Boston (Kroll, Wrenn, Grimaldi, Campbell, Raynor, Dawson, Irwin, Pires, Giacalone, Tuohy, Fromson, Gitlin); Department of Psychiatry, Harvard Medical School, Boston (Kroll, Grimaldi, Raynor, Dawson, Giacalone, Fromson, Wolfe, Gitlin); Department of Psychiatry, Newton-Wellesley Hospital, Boston (Wolfe).
Objective:
The authors sought to determine whether a walk-in psychiatry model with longitudinal follow-up capability could improve access for patients who traditionally miss appointments.
Methods:
An urgent care clinic that offers treatment exclusively on a walk-in basis was opened within an adult psychiatry practice to accommodate patients who missed prior scheduled appointments. Electronic health records for patients who received an initial psychiatry evaluation at the practice during a 6-month period (N=355) were reviewed retrospectively to track the clinic's productivity and patient demographic characteristics.
Results:
Eighty patients (23%) accessed their initial psychiatry encounters through the walk-in clinic. Medicaid recipients (odds ratio [OR]=1.89, 95% confidence interval [CI]=1.10-3.24) and individuals without a college degree (OR=1.86, 95% CI=1.04-3.32) were more likely than patients with other insurance carriers and those with a college degree, respectively, to access care through a walk-in encounter versus a scheduled appointment.
Conclusions:
Longitudinal walk-in psychiatry services can feasibly be offered through the longitudinal urgent care psychiatry model. This model may serve as a unique access point for patients from historically underserved groups.
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