General Practice-led urgent care practice vs. emergency room – satisfaction of ambulatory patients with low urgency medical problems

TL;DR

Patients with low urgency medical problems were more satisfied with urgent care practices than emergency rooms, especially regarding waiting times.

Contribution

The study compares patient satisfaction between urgent care practices and emergency rooms for low urgency cases.

Findings

More UCP-patients deemed their waiting time appropriate compared to ER-patients.

UCP-patients were more likely to be very satisfied with the treatment they received.

UCP-patients had a shorter overall length of stay compared to ER-patients.

Abstract

Emergency room (ER) utilisation by ambulatory patients with low urgency medical problems leads to ER-capacity use and long waiting times. Establishing General Practice (GP)-led urgent care practices (UCP) adjacent to ERs allows to triage patients from the ER to the UCP. However, patients may perceive themselves as ER-cases and expect ER-treatment including extensive diagnostics.

To assess UCP-patients’ satisfaction compared to ambulatory ER-patients.

Sub-analysis (11/2019–01/2020) of a prospective, monocentric observational study at the University Medical Centre Hamburg-Eppendorf ER and co-located UCP focusing on patient survey data including demographics, waiting time and diagnoses. Satisfaction, uncertainty and appropriateness of waiting time was assessed with 4-point Likert-scales.

Analysing 1196 UCP- and 597 ER-patients, patient satisfaction correlated positively with perceived appropriate waiting time in both groups. But more UCP-patients deemed their waiting time appropriate (76.7% vs. 70.4%; p = 0.004) and reported to be very satisfied with the treatment (64.7% vs. 55.8%; p < 0.001). Time until the first physician contact was nearly equal, but the entire length of stay was shorter in the UCP (104 ± 88.0 min vs. 179 ± 301 min; p < 0.001). In both groups, satisfaction was reduced by on-going uncertainty after the visit, but uncertainty was higher among UCP-patients (32% vs. 25%; p = 0.003). Age, gender or diagnosis had no influence on patients’ satisfaction. More UCP-patients stated that today’s problem could have been treated by a GP (57% vs. 15%; p < 0.001) and were advised to follow up in an outpatient setting.

Treating patients in an UCP does not lead to overall dissatisfaction.

Emergency room (ER)- and urgent care practice (UCP)-patients’ satisfaction correlated positively with a perceived appropriate waiting time, but more UCP-patients stated that their waiting time was appropriate.

Satisfaction correlated negatively with on-going uncertainty after the visit; uncertainty was higher among UCP-patients.

Age, gender or diagnosis had no influence on patients’ satisfaction.

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