Emergency! Yes? No. Urgent Care Centers Are on the Rise, Filling in the Care Gap for Elders

By Levine, Carol | Aging Today, September/October 2011 | Go to article overview

Emergency! Yes? No. Urgent Care Centers Are on the Rise, Filling in the Care Gap for Elders


Levine, Carol, Aging Today


Ruth Willig is no stranger to healthcare. Now 87, she worked for many years in a lab as a microbiologist. The assisted living facility where she now lives in Brooklyn, N.Y., is close to all her doctors and healthcare facilities, and to her daughter, Judy.

But when Ruth lived in suburban New Jersey, help was not so close. On several occasions when she needed medical care and her doctor's office was closed, she turned to an urgent care center instead of going to the hospital emergency department. "Once, just before a trip, I became shaky and dizzy," she said. "I was taken to the urgent care center, where they decided I did need to go to the hospital. After a very long wait in emergency, I was admitted."

Another time she fell at home, hitting her head and bruising her leg. A neighbor took her to the urgent care center, where a doctor examined her, found nothing serious and sent her home. "If the urgent care center weren't so convenient," she recalls, "I might have avoided going anywhere. I'm not a panic-button person."

Through her mother's experiences, Judy Willig, executive director of Heights and Hills, a Brooklyn agency that serves an elderly population, is very familiar with urgent care centers. But many specialists in aging services, as well as their clients and their families, know little about what these centers can and cannot provide. That's not surprising considering urgent care centers are a relatively new phenomenon. There are approximately 8,700 urgent care centers in the United States, and only about half have been in business five years or more.

Filling the Care Delivery Gaps

Urgent care centers have grown rapidly to fill gaps caused by a lack of timely access to medical appointments, a shortage of primary care doctors and long waits in the hospital emergency rooms. The situation isn't likely to improve soon. From 1990 to 2009, the number of hospital emergency departments in non-rural areas declined by 27%, while the number of visits to emergency rooms increased by 30%, according to a May 2011 report published in the Journal of the American Medical Association.

In this challenging healthcare environment, investors and corporations have seen urgent care centers as economic opportunities; physicians have formed such centers to expand their practices; and hospitals and healthcare systems have created them to ease pressure on their expensive emergency departments. The array of options can be confusing.

The ABCs of Urgent Care

Like any new model, information is required to use the centers safely and appropriately. And it has been difficult to find such information beyond marketing copy. One problem is the name. "Urgent care center" is the generic name, but these facilities go by all sorts of names- immediate care center, drop-in center, walk-in center- to say nothing of brand names like FastMed. Urgent and immediate care centers offer similar services, but operate under different state regulations. The Urgent Care Association of America (UCAA) (www.ucaoa.org/index.php) has information on credentialing and accreditation.

Whatever they're called, urgent care centers are not for life-threatening conditions like severe breathing problems, chest pains or uncontrolled bleeding. Ruth WiIlig's dizzy spell is an example of a situation in which an emergency room visit was deemed necessary for further tests. The United Hospital Fund's free "Emergency Room Visits: A Family Caregiver's Guide" (http://bit.ly/qi7x2G) includes a list of conditions that definitely require emergency room treatment. Nor is an urgent care center a substitute for an ongoing relationship with a primary care doctor.

Urgent care centers are designed to treat non-emergency emergencies- problems that are not life-threatening, but that still need immediate attention by a doctor or nurse practitioner: sprained ankles, badly cut fingers, painful sore throats or sinus and urinary tract infections. …

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