Summary
Patients have many alternatives to a hospital emergency room when they need medical care for an illness or injury that occurs at night or on the weekend: Urgent care centers, retail clinics, virtual physicians who diagnose over the internet, nurse advice lines ― and ― in some major cities ― physicians who make house calls. But what care settings are patients likely to choose?
To answer this question, authors surveyed over 5,000 employees at the University of California, Irvine campus, a diverse population representing all socioeconomic strata. Based on an analysis of their responses, authors created a publicly available simulation model that allows users to understand what care settings are most likely to be chosen by different populations when faced with different clinical situations. The general findings:
- Patients are more likely to choose less costly care settings and settings with less wait time, but that cost is more important than wait time.
- Both those choices depend on the severity of the injury or the disease.
- Travel time does not affect choice.
The model can inform policymakers and researchers in their efforts to understand the complex relationships between out-of-pocket costs, wait time, severity of the medical condition, and population characteristics that influence the choice of care setting.