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

​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. 


Publication Authors:

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