Urgent Care Utilization in a Pediatric Population With Private Health Insurance

Abstract

Introduction: Pediatric urgent care (UC) utilization patterns have been studied in Medicaid enrollees, but not in those with private insurance.

Methods: Utilization patterns of UC at a suburban pediatric primary care practice with patients with private health insurance were reviewed. Descriptive data were obtained.

Results: Three hundred twenty-five charts were reviewed. Most UC visits were for children under 6 years of age (59.7%), a diagnosis of fever (12.2%), and with low severity illness (57.8%). Seventy percent occurred during weekdays and during times when the primary care practice was open. Most children (67.4%) had a diagnostic test performed at UC and 42.2% received a prescription for antibiotics.

Discussion: Primary care providers should target caregiver education on low acuity conditions and consider process improvements to accommodate urgent visits. While pediatric UC benchmarks are needed, data suggests that general UCs are at risk for overprescribing antibiotics compared to national ambulatory averages.

Keywords: Urgent care; acute care; ambulatory care; pediatrics; utilization.