Hospitals trying to ease strained emergency rooms (ERs) and to overcome a lack of primary care physicians are embracing urgent care centers, according to a new report by Kaiser Health News (Washington DC, USA).

Across the United States, an estimated three million patients visit urgent care centers every week, according to the Urgent Care Association of America (Chicago, IL, USA). To meet increased demand, the number of facilities has steadily increased from 8,000 in 2008 to more than 9,200 in 2011, with about 600 new urgent centers opened this year. Urgent care centers are poised to attract even more patients in 2014, when the US federal health law begins to expand health coverage to 32 million American citizens.

Crowded emergency rooms and a lack of primary care doctors are the main reason for this trend, but another important reason is an economic one: the drive to lower costs. Urgent care centers' fees are at least half those charged at a hospital ER for the same condition, although they are similar to what physicians charge for office visits. Still, the savings in ER costs are a big draw for patients without insurance, as well as insured patients facing higher out-of- pocket costs because of rising deductibles. Those lower fees have also drawn the attention of hospitals and insurers, both of which increasingly see the facilities as a way to hold down costs and boost their bottom lines.

Urgent care centers typically treat a wide range of injuries and illnesses--including coughs and colds, broken bones, cuts, and back pain--and do blood and urine tests, X-rays, and even drug testing. They see patients without an appointment and often are open evenings and weekends. Unlike small retail health clinics that have opened in the past decade in department stores and pharmacies and mainly employ nurse practitioners, urgent care centers usually have physicians on site. About half of the facilities are owned by doctors, and 28% are hospital-owned. However, urgent care centers also have negative aspects.

“Urgent care is not as good as having a regular physician,” said Glen Stream, MD, president of the American Academy of Family Physicians (Leawood, KS, USA). “No one really gets to know them if they use a different urgent care each time. One of the best predictors of health outcomes is having a usual source of care where you can go for acute and chronic illnesses and develop a relationship with a doctor.”

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