ArticleThe Permanente journal2025
Comparing Care Delivery Efficiency Between Emergency Department and Oncology Urgent Care.
Article in The Permanente journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
introductionAdults often visit the emergency department (ED) for complications from cancer treatment. Oncology urgent care clinics (UCCs) can manage nonemergent issues, but little is known about how UCC care compares with ED care.
methodsThe authors' university hospital ED and UCC visits (January 1, 2023, through June 30, 2023) were analyzed after coding the Emergency Severity Index (ESI) for UCC visits to make them comparable to ED visits, where ESI was already regularly assigned. ESI ranges from levels 1 to 5 (1 = highest severity). Coarsened exact matching and multivariate models were used to compare the proportion of patients discharged home, the length of stay, and advanced imaging use. Marginally adjusted outcomes were stratified by ESI.
resultsPrior to matching, 31.7% of UCC and 64.0% of ED visits were ESI level 2 severity; 61.0% of UCC and 33.4% of ED visits were ESI level 3. Matching resulted in 1033 UCC and 2782 ED visits (61.0% of patients > age 65; 47.8% female; 65.9% non-Hispanic White). In adjusted analyses, for ESI level 2 visits, the UCC discharged patients home 32.0% more often than the ED (95% confidence interval [CI], 27.5-36.4), with a 7.0-hour shorter length of stay (95% CI, 6.5-7.5), and used advanced imaging 30.3% less often (95% CI, 26.0-34.7). Findings were similar for ESI level 3 visits. DISCUSSION: The UCC managed a high level of severity and may be more efficient than the ED for nonemergent care.
conclusionFuture work should more broadly investigate care delivery at each site, including the cost of care.
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