Differences in Total Healthcare Costs and Out-of-Pocket Costs for Non-Urgent Visits to Emergency Departments and Urgent Care Centers

Abstract

Objective: The 2014 Truven Health MarketScan® Commercial Claims and Encounters Database was used to determine the existence and magnitude of differences in total healthcare costs and patient out-of-pocket costs between urgent care centers and hospital emergency departments for the treatment of adult patients presenting with non-urgent conditions. Methods: Propensity-score matching was used to eliminate, as much as possible, potential selection bias. Linear and logistic regression models were used to investigate relationships between the outcome variables and location of service, controlling for age, gender, geographic location, commercial insurance plan type, and clinical comorbidities. Results: Mean total adjusted episode costs of $1,240 for patients who presented at a hospital emergency department with a non-urgent condition were 4.8 times greater than costs of$257 for patients presenting at an urgent care center. Furthermore, the patient portion of the mean adjusted total episode costs of $351 was 3.5 times greater for patients presenting at a hospital emergency department. Conclusion: The US healthcare system, and patients and families, could significantly reduce costs of care by selecting the most appropriate setting for treatment of non-urgent conditions