Emergency Department Visit-Severity Algorithm for Immediate Care Clinic Visits.

Area of Science:

• Healthcare Management
• Public Health
• Health Services Research

Background:

• Immediate care clinics (ICCs) manage acute, low-severity visits, diverting patients from emergency departments (EDs).
• ED crowding negatively impacts care quality, efficiency, and patient satisfaction.
• Optimizing ICC use for non-emergent conditions can alleviate ED pressures and control healthcare costs.

Purpose of the Study:

• To apply the Billings/Ballard severity algorithm to ICC visits over seven years.
• To compare ICC visit characteristics and severity distributions with published ED data.
• To identify common diagnoses and patient characteristics associated with ICC utilization.

Main Methods:

• Analysis of 306,395 ICC visits from 125,063 unique patients within an academic health system.
• Utilized negative binomial and multivariate regression analyses to assess visit associations and severity.
• Classified International Classification of Diseases, 9th and 10th modifications (ICD-9/10) codes by severity.

Main Results:

• 9.17% of ICC visits were emergent, 81.25% non-emergent, contrasting with ED distributions.
• Non-emergent presentations were more common in ICCs, with upper respiratory infections as a frequent diagnosis.
• 47% of patients had repeat ICC visits and 41% had primary care follow-up within one year.

Conclusions:

• ICCs predominantly provide non-emergent care, supporting their role in reducing ED crowding.
• High rates of repeat visits and primary care follow-up indicate care continuity.
• Disparities in ICC use and emergent condition presentation exist across insurance types, necessitating improved accessibility.