Anecdotal evidence that urgent care is a safe, lower-cost alternative to the emergency room and a more convenient setting than the primary care office is abundant. What about properly designed research that provides hard data, though? The Urgent Care Association of America has made great strides toward validating industry standards with its annual, voluntary benchmarking survey, but otherwise the industry has lagged in researching itself. Now Intermountain Healthcare has taken a step toward filling the void in clinical factors common in urgent care by looking at 1.7 million adult patient visits to its 28 Intermountain InstaCare (urgent care) clinics over a 6-year period.
Published in the Western Journal of Emergency Medicine and led by Intermountain’s James Hart, MD and Mike Woodruff, MD, the study turned up distinct relationships between heart rate, systolic blood pressure, and adverse short-term outcomes after an urgent care visit among certain patient populations. For example, blood pressure ranges for patients visiting InstaCare tended to be higher than would typically considered “normal,” especially among older age groups. And yet, patients with relatively lower blood pressure look to be at greater risk for adverse short-term outcomes. All this led the researchers to hypothesize that some combination of age and certain vital signs might help predict “clinical deterioration” in patients after an urgent care visit.
The value in such data is that they derive from a large dataset. While such scale would be hard to duplicate in most urgent care operations—Intermountain has 22 hospitals and 185 clinics, after all—they can provide deeper insight into the overall setting as well as a point of reference for operators and clinicians. And any data that help estimate patient risk at the point of care goes further in establishing urgent care as a safe, appropriate setting for many complaints that would have been considered emergent in years past.