Pediatric Emergency Transfers Following Virtual Urgent Care Visits.

Area of Science:

• Pediatric Health
• Digital Health
• Healthcare Disparities

Background:

• The COVID-19 pandemic accelerated telemedicine adoption, including virtual urgent care (VUC), aiming to improve healthcare access and reduce nonemergent emergency department (ED) visits.
• Understanding postpandemic VUC utilization in pediatric populations is crucial for optimizing its role as an accessible healthcare resource.

Purpose of the Study:

• To describe postpandemic virtual urgent care (VUC) utilization among children.
• To determine VUC-to-emergency department (ED) referral rates and associated outcomes in pediatric patients.
• To identify demographic factors influencing VUC utilization and referral patterns.

Main Methods:

• A retrospective cohort study analyzed 4676 pediatric VUC visits from March 2021 to February 2023.
• Data included patient demographics, VUC referral status (physician-referred vs. self-referred), and ED care and disposition.
• Logistic regression was used to examine factors associated with VUC-to-ED referrals.

Main Results:

• Patients preferring English, non-Hispanic individuals, and those with commercial insurance were more likely to complete VUC visits (72%).
• Physician referrals from VUC to the ED occurred in 5.9% of cases, with a 19% admission rate; 5% self-referred to the ED with a 6% admission rate.
• Medicaid insurance was associated with twice the odds of a self-referred VUC-to-ED visit, despite lower admission rates.

Conclusions:

• Postpandemic VUC demonstrates low referral rates to the ED in pediatric patients.
• Persistent disparities in VUC utilization exist, particularly for patients with Medicaid.
• Further research is needed to enhance VUC accessibility and equity in pediatric healthcare.