# 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.

## Key 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.