Community Based Urgent Care centres with an Integrated care model
Urgent Care is the episodic medical treatment of non-life-threatening illnesses or injury that do not require immediate attention in an Emergency Department (ED), but, nevertheless require medical management within 24 hours to prevent serious deterioration of health (RNZCUC, 2017).
Traditionally, Urgent Care is provided in dedicated Urgent Care Units which have access to on-site radiology and pathology diagnostics, are open longer hours than traditional primary care practices and accept patients on a walk-in basis (Ho et al., 2017; Weinick, Bristol, & DesRoches, 2009).
Successful Urgent Care Units are typically set a distance from hospitals and their associated Emergency Departments (Weinick, Burns et al. 2010).
General Practitioners (GPs), Nurse Practitioners, Urgent Care Physicians (New Zealand) and Family Physicians (USA) provide medical services in Urgent Care Units (Hider, Lay-Yee, & Davis, 2007; Weinick et al., 2009)
Benefits of Urgent Care Units
Improve Access to Care
Patients have indicated that Urgent Care Units improve access to care after-hours and offer a more convenient option to an Emergency Department for those unable to schedule a regular primary care appointment (Coster, Turner, Bradbury, & Cantrell, 2017).
Integrating primary, acute and extended care in a single setting has been shown to enhance the likelihood of patient engagement with primary care practitioners and improve efficiency and outcomes for their local population (Swerissen & Duckett, 2016)
Lower Emergency Department Presentations Rates
Auckland’s average ED presentation rate (184 per 1,000 population) is 40% lower than Australia’s (311 per 1,000 population) which is attributed to the effective provision of Urgent Care in the New Zealand capital (Clearwater, 2014).
American, English and Australian studies have indicated that between10%-43% of patients attending EDs could be handled more appropriately in Urgent Care Units (Thompson, Lasserson, McCann, Thompson, & Heneghan, 2013; Weinick, Burns, & Mehrotra, 2010; Yusuf Nagree et al., 2013).
In Australia, proportionately more of these patients are presenting to ED during normal business hours, reflecting it is not a GP shortage that driving ED presentations but a service availability (Yusuf Nagree et al., 2013).
Lower Cost of Care
Cost of care in Urgent Care Units has been estimated to be $228-$414 per occasion of service less than Emergency Departments (Weinick et al., 2010).
Urgent Care services are not currently established in Australia because:
- There is limited scope for funding Urgent Care provided under the Medicare Benefits Scheme (MBS) (Department of Health, 2018);
- Most primary practices do not have appropriate infrastructure to support Urgent Care services (Adie, Graham, & Wallis, 2017);
- The majority of the medical workforce is not appropriately skilled or has been de-skilled over time and is therefore unwilling or unable to support Urgent Care (Adie et al., 2017).
Why the contribution is important
The development of commuity based urgent care centres with integration to primary care is an evidence based model that has been successfully trialed and developed overseas.
It is time for Australa to now demonstrate this a a sustainable model of care and a longterm solution
by ejones on August 12, 2019 at 12:19PM