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Where Do Patients Go? How Patients Choose Between Care Settings for Minor Illnesses and Injuries

September 23, 2019

Policy Brief

Authors: Dana B. Mukamel, PhD, MS, Alpesh Amin, Heather Ladd, Dara H. Sorkin, PhD

​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. 

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