Sabrina Lenzen, University of Queensland - Emergency department attendance and waiting

Title: The effect of urgent care centers on emergency department attendance and waiting

Abstract: The timeliness of hospital Emergency Department (ED) care continues to deteriorate in many countries around the world. Urgent care centers (UCCs) represent an alternative practice model that has recently been proposed and introduced in the state of Queensland, Australia, aimed at reducing non-urgent ED attendance. To examine the impact of this policy, we exploit the staggered opening of UCCs, studying their effects on ED attendance, waiting time to be seen, and nearby general practice attendance, using three modern difference-in-differences estimators and a generalized synthetic control method. We show that, while the number of ED presentations declined, they did so for only one treatment cohort, for which presentation numbers pre-treatment had seen a different trajectory compared to the controls, and thus we cannot conclude the decline was caused by the UCCs' opening. We find that the UCCs did not improve the timeliness of care provided, nor reduce the rate of attendance at local general practices. However, we find a striking 32% increase in the total number of presentations across the ED and UCCs combined. Potential mechanisms may be the lower time-price for UCC care, exposing latent demand. These findings have policy implications: when healthcare providers consider opening a UCC, the result may be a satisfaction of latent demand, rather than a reduction in ED attendance or waiting times.

Presenter:  Sabrina Lenzen, Centre for the Business and Economics of Health, University of Queensland

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