2014 ACEP URGENT C POLL RESULTSfilecache.mediaroom.com/mr5mr_acep/178517/download/...2014 ACEP...

2014 ACEP URGENT CARE POLL

RESULTS

PREPARED FOR:

PREPARED BY:

625 North Washington Street, Suite 450

Alexandria, VA 22314

800.644.6646 toll free

703.739.1000 telephone

703.549.6057 fax

www.MarketingGeneral.com

© 2014 Marketing General Incorporated

2014 ACEP Urgent Care Poll Results

Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000

Page 1

Table of Contents

Study Background ...................................................................................................................................... 2

Sample Characteristics ............................................................................................................................... 3

Findings ........................................................................................................................................................ 8



Page 2

Study Background

This survey is designed to capture a snapshot of the current trends in emergency medicine.

Invitations to participate were sent on September 1, 2014, to a list of 26,900 current ACEP

members.

Of the 26,900 email invitations sent, 1,382 emails bounced, resulting in a net total of 25,518 sent

invitations. To boost response rates, a reminder email was sent to non-responders and non-

completers on September 4th

. A final reminder email was sent the morning the survey closed on

September 8th

.

The survey officially closed on September 8th

at 11:59 p.m. EDT. Those respondents who

indicated they only worked at an urgent care center were terminated from the study, as they were

unable to answer the majority of the questions that asked about emergency departments.

Therefore, a total of 2,853 surveys were completed, providing a response rate of approximately

11% and a margin of error of 1.8%. The margin of error, or standard error, is a statistical term

used to measure the random fluctuations inherent in samples; the smaller the standard of error,

the more accurate the measurement of the population or universe.

This study’s significance level of .05 carries with it a 95 percent confidence interval. The

confidence interval is established as the likelihood that the same results would be achieved in a

similar study, meaning that if we were to conduct this study 100 times, the same results plus or

minus the margin of error (1.8%) would occur 95 out of 100 times.



Page 3

Sample Characteristics

Number of Responses per State

STATE COUNT PERCENT STATE COUNT PERCENT

Alabama 33 1% Missouri 54 2%

Alaska 11 -- Montana 8 --

APO AE 2 -- Nebraska 16 1%

Arizona 52 2% Nevada 11 --

Arkansas 10 -- New Hampshire 23 1%

California 230 8% New Jersey 74 3%

Colorado 66 2% New Mexico 21 1%

Connecticut 47 2% New York 214 8%

Delaware 20 1% North Carolina 89 3%

District of Columbia 9 -- North Dakota 3 --

Florida 123 4% Ohio 123 4%

Georgia 73 3% Oklahoma 25 1%

Guam 1 -- Oregon 56 2%

Hawaii 10 -- Pennsylvania 177 6%

Idaho 12 -- Puerto Rico 5 --

Illinois 131 5% Rhode Island 25 1%

Indiana 53 2% South Carolina 43 2%

Iowa 21 1% South Dakota 7 --

Kansas 17 1% Tennessee 30 1%

Kentucky 31 1% Texas 205 7%

Louisiana 33 1% Utah 29 1%

Maine 19 1% Vermont 8 --

Maryland 67 2% Virginia 89 3%

Massachusetts 71 3% Washington 90 3%

Michigan 136 5% West Virginia 9 --

Minnesota 60 2% Wisconsin 60 2%

Mississippi 17 1% Wyoming 4 --



Page 4

Top 11 Participating States

STATE COUNT PERCENT

1. California 230 8%

2. New York 214 8%

3. Texas 205 7%

4. Pennsylvania 177 6%

5. Michigan 136 5%

6. Illinois 131 5%

7. Florida 123 4%

8. Ohio 123 4%

9. Washington 90 3%

10. North Carolina 89 3%

11. Virginia 89 3%



Page 5

1. What is the emergency department patient volume where you work the majority of

your time?

About 41% of respondents work in emergency departments with up to 50,000 patients. 44% of

respondents work in facilities with a patient volume between 50,001 and 100,000. The largest

percentage of participants (25%) report working in an emergency department with a patient

volume between 50,001 to 75,000.

4%

1%

0%

1%

9%

19%

25%

12%

12%

9%

6%

2%

0% 5% 10% 15% 20% 25% 30%

Work only at an urgent care center

Not sure

More than 200,000

151,000-200,000

100,001-150,000

75,001-100,000

50,001-75,000

40,001-50,000

30,001-40,000

20,001-30,000

10,001-20,000

Up to 10,000

n = 2,853



Page 6

2. Are you involved in any way (e.g., ownership, management, staff, etc.) with urgent

care centers?

A large majority of respondents (82%) report that they are not involved in urgent care centers

in any way.

18%

82%

Yes

No

n = 2,812



Page 7

3. In what type of geographic area is your emergency department located?

Nearly one half of participants (47%) indicate that they work in an urban emergency

department.

47%

40%

13%

Urban

Suburban

Rural

n = 2,744

n =2,744



Page 8

Findings

4. What percentage of patients in your emergency department are self-pay?

41% of respondents report that approximately 11% to 25% of patients are self-pay.

22%

1%

1%

3%

15%

41%

17%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Not sure

None

More than 75%

51-75%

26-50%

11-25%

Up to 10%

n = 2,738



Page 9

5. What percentage of patients in your emergency department are Medicaid recipients?

About one third of respondents (34%) indicate that between 11% and 25% of their patients

receive Medicaid. Further, 28% report that 26%-50% of patients in their emergency department

are Medicaid recipients.

24%

1%

1%

6%

28%

34%

6%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Not sure

None

More than 75%

51-75%

26-50%

11-25%

Up to 10%

n = 2,738



Page 10

6. In the past year, has at least one urgent care center or more operated within 10 miles

of your emergency department?

86% of participants report that at least one urgent care center operates within 10 miles of their

emergency department, with 76% indicating more than one in operation.

10%

76%

7%

8%

Yes, only one

Yes, more than one

No

Not suren = 2,745



Page 11

7. In the past year, has the number of visits to your emergency department been

affected by an urgent care center operating within 10 miles of your emergency

department?

Over one-third of respondents (37%) have noticed a change in the number of patients visiting

the emergency department as a result of a local urgent care center. 21% have reported a

decline in emergency visits while 16% have reported an increase in emergency visits. 39% of

respondents indicate that over the last year there has been no change in the number of visits to

their emergency department due to an urgent care center operating within 10 miles.

21%

16%

39%

24%

Yes, emergency visits have decreased

Yes, emergency visits have increased

No, there has been no change

Not suren = 2,342



Page 12

8. In your opinion, how is the growth in urgent care centers affecting the use of health

care resources (such as physician visits, medical tests, procedures, etc.)?

40% of participants indicate that there has been an increase in the use of health care resources

due to the growth in urgent care centers, while 22% report that there has been no change in

the use of health care resources.

40%

9%

22%

29%

Increasing use of health care resources

Decreasing use of health care resources

No change in use of health care resources

Not sure

n = 2,659



Page 13

9. Has the growth of urgent care centers caused a change in the types of patients you

see?

43% of respondents indicate that the growth of urgent care centers has not caused a change in

the types of patients they see, while 29% report that they have seen only a little change in the

types of patients seen.

15%

29%

43%

14%

Yes, significant change

Yes, little change

No change

Not suren = 2,556



Page 14

10. How have your patients changed as a result of the growth in urgent care centers?

Check all that apply.

An overwhelming majority of respondents (77%) report that the main change due to the

growth in urgent care centers is that they see patients with more complicated issues. 54%

report their patients are less insured, and 53% say that their patients have a lower income.

6%

1%

2%

3%

4%

39%

53%

54%

77%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Other

Higher income

More insured

Less complicated issues

Younger

Older

Lower income

Less insured

More complicated issues

n = 1,090



Page 15

11. Will urgent care centers pull more patients from emergency care or primary care?

Just over half of participants (51%) indicate that urgent care centers will pull patients from both

emergency care and primary care, while nearly a quarter of respondents (22%) report that

urgent care centers will pull more patients from primary care.

8%

6%

13%

22%

51%

0% 10% 20% 30% 40% 50% 60%

Not sure

Neither

Emergency care

Primary care

Both

n = 2,663



Page 16

12. Are urgent care centers in your area marketing themselves as alternatives to the

emergency department?

More than half the participants (54%) report that urgent care centers in their area are

marketing themselves as alternatives to the emergency department. 21% indicate that only

some of the urgent care centers are doing so.

54%

21%

15%

10%

YesSome, but not allNoNot sure

n = 2,659



Page 17

13. Should urgent care centers be subject to EMTALA regulations?

Nearly half of respondents (49%) indicate that urgent care centers should be subject to EMTALA

regulations, while 39% disagree.

49%

39%

12%

Yes

NoNot sure

n = 2,661



Page 18

14. Should states have specific staffing or equipment criteria for urgent care centers?

A large majority of participants (72%) believe that states should have specific staffing or equipment criteria for urgent care centers. 18% of respondents, however, do not think states should have such criteria for urgent care centers.

72%

18%

9%

1%

Yes

No

Not sure

n = 2,662



Page 19

15. How often are patients referred to your emergency department from an urgent care

facility?

Over half the participants (54%) report that patients are referred to their emergency

department from urgent care centers more than once a day. Only 1% of respondents indicate

that patients are never referred to their emergency department from an urgent care center.

5%

1%

1%

4%

19%

17%

54%

0% 10% 20% 30% 40% 50% 60%

Not sure

Never

Once or twice a year

Once or twice a month

Once or twice a week

Once a day

More than once in a day

n = 2,556



Page 20

16. What are the primary reasons that patients are redirected to an emergency

department from an urgent care facility? (Select top 2 reasons.)

A vast majority of participants (90%) report that patients were redirected to the emergency

department because the medical condition was potentially more serious than the patient

thought. Further, 65% indicate that the patient was redirected to the emergency department

from the urgent care center because of the limited equipment and staffing at the urgent care

center.

6%

3%

14%

65%

90%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Other (please specify)

Could not get a timely appointment

Did not have appropriate insurance or ability to payat time of urgent care visit

Limited equipment and staffing compared toemergency department

Medical condition was potentially more serious thanpatient thought

n = 2,623



Page 21

17. Of your patients who could have been safely treated at an urgent care center, why did

they choose to go to the emergency room? (Select top 2 reasons.)

According to 44% of respondents, patients chose to go to the emergency department although

they could have been safely treated at an urgent care center because of a lack of appropriate

insurance or inability to pay the urgent care center. One third of participants (33%) also say that

another primary reason is that the patient thought the emergency room was a better option.

4%

14%

19%

21%

22%

31%

33%

44%

0% 10% 20% 30% 40% 50%

Other (please specify)

Perception that the quality of care at emergency room issafer

Unfamiliarity with urgent care centers

Could not get in to see a physician in a timely manner(either appointment or walk-in)

Urgent care center was closed

Patients thought symptoms indicated a medical emergency

Patient thought emergency room was a better option totake care of them

Did not have appropriate insurance or ability to pay urgentcare center

n = 2,494



Page 22

18. Are urgent care centers in your area staffed by physicians on site?

44% of participants indicate that some of the urgent care centers in their area are staffed by

physicians on site, but not all of them are. Moreover, 40% report that all the urgent care

centers in their area are staffed by physicians on site.

5%

10%

40%

44%

No

Not sure

Yes

Some, but not all

n = 2,654



Page 23

19. Do urgent care centers in your area have access to on-call specialists?

Just over one third of participants (35%) indicate that the urgent care centers in their area do

not have access to on-call specialists. However, 22% of respondents report that some urgent

care centers do have access to such specialists, while 9% say the urgent care centers in their

area do have access to on-call specialists.

9%

22%

34%

35%

Yes

Some, but not all

Not sure

No

n = 2,659



Page 24

20. Do urgent care centers in your area take Medicaid?

Only 14% of respondents indicate that urgent care centers in their area take Medicaid, while

21% say that some urgent care centers do, but not all of them. 19% of participants say that

urgent care centers in their area do not take Medicaid.

14%

19%

21%

46% YesNoSome, but not allNot sure

n = 2,658



Page 25

21. Do urgent care centers in your area have a triage process?

Only 20% of respondents indicate that the urgent care centers in their area have a triage

process. 13% of participants report that urgent care centers near them do not have a triage

process. Only 4% say that triage is not needed at the urgent care centers in their area.

20%

13%

4%

63%

YesNoTriage not neededNot sure

n = 2,658

n = 2,655



Page 26

22. How many patients would you estimate your emergency department treated in the

past year that first went to urgent care centers for life-threatening conditions (e.g.,

chest pain, stroke symptoms, difficulty breathing, etc.), instead of going directly to the

emergency room?

About 30% of respondents report that over the past year their emergency department has

treated up to 100 patients who originally went to urgent care centers for life-threatening

conditions, and close to one-quarter (23%) indicate that 101 – 400 were patients who originally

went to an urgent care center were treated in their emergency department for a life-

threatening condition. 9% of respondents report their emergency department had more than

1,000 patients who originally went to an urgent care center for a life-threatening condition.

25%

1%

9%

8%

4%

7%

7%

9%

6%

5%

8%

11%

0% 5% 10% 15% 20% 25% 30%

Not sure

None

More than 1,000

501-1,000

401-500

301-400

201-300

101-200

76-100

51-75

26-50

1-25

n = 2,537



Page 27

23. How concerned are you that patients with serious medical conditions may go to

urgent care centers first before going to the emergency department?

A total of 76% of participants indicate that they have at least some concern about patients with

serious medical conditions going to an urgent care center before going to the emergency

department. Less than one quarter of participants (23%) say that they are not at all concerned.

20%

56%

23%

2%

Very concerned

Somewhat concerned

Not at all concerned

Not sure

n = 2,647



Page 28

24. What percentage of patients can determine for themselves whether or not they

require emergency care?

Nearly one quarter of participants (24%) indicate that between 11% and 25% of patients can

determine for themselves whether they require emergency care. Moreover, 24% of

respondents believe that between 26% and 50% of patients can determine for themselves if

they need emergency care.

11%

3%

8%

13%

24%

24%

18%

0% 5% 10% 15% 20% 25% 30%

Not sure

No patients

More than 75%

51-75%

26-50%

11-25%

Up to 10%

n = 2,651

2014 ACEP URGENT C POLL RESULTSfilecache.mediaroom.com/mr5mr_acep/178517/download/...2014 ACEP...

Documents

Transcript of 2014 ACEP URGENT C POLL RESULTSfilecache.mediaroom.com/mr5mr_acep/178517/download/...2014 ACEP...