Impact on an Urgent Care Clinic of a New Freestanding Emergency Department in a Resource-Scarce Area

Background: Convenience clinics-such as urgent care centers (UCCs), retail clinics, and freestanding emergency departments (FSEDs)-where patients can receive treatment for a variety of medical conditions have increased in number and popularity. We quantify the impact an FSED had on UCC visits in an underserved area in North Baton Rouge, Louisiana. Methods: All FSED and UCC visits were abstracted from 2015 to 2020. Visits were classified using International Classification of Diseases, Tenth Revision codes. We used a time series analysis to evaluate the association of nonemergent and emergent visits to the UCC after the opening of the FSED. Visits were also aggregated at the census block group (neighborhood) level. Demographic characteristics and the neighborhood Area Deprivation Index were used to compare UCC utilization before and after the FSED opened and to describe the visits to the UCC and the FSED. Results: We found a difference in the demographic composition of patients presenting to the UCC after the FSED opened. Emergent visits decreased at the UCC, but nonemergent visits did not change after the FSED opened. The majority of visits to the FSED were nonemergent, and the proportion of nonemergent visits to the FSED increased during the hours that the UCC was closed. The majority of visits to the FSED came from neighborhoods with a high Area Deprivation Index. Conclusion: The opening of an FSED resulted in a reduction of emergent visits to the UCC without impacting the number of nonemergent visits. The opening of an FSED in a poor, healthcare-resource-scarce area resulted in significantly more patients from deprived neighborhoods being treated at the FSED and UCC.