Urgent-care centers: Illinois numbers grow as time-pressed families seek low-cost option to ERs

side note: I have noticed quite a few of these Urgent-care centers pop-up all over the place in the Chicagoland area. There does seem to be a lack of oversight and accreditation though….will this cause issues in the future?

Chicago Tribune
by Judith Graham & Melissa Healy
But potential patients should evaluate their own symptoms and a center’s services, hours and staff credentials

When his 2 ½ -year-old daughter tripped at day care and cut her chin recently, Lance Moore didn’t take her to the emergency room at the nearest hospital. Instead he rushed her to an urgent-care center.

“I wanted her to get immediate attention,” said Moore, who’d been to the St. Charles center before and knew the doctor who gave his daughter five stitches. “He offered to call a plastic surgeon, although he said he didn’t think that was necessary,” said Moore, who lives in Carol Stream. “He did a real nice job.”

Urgent-care centers have been gaining ground in Illinois and across the country recently as an attractive medical option for time-pressed families trying to avoid spending hours in a hospital ER or days waiting for a doctor’s appointment.

Sometimes known as “docs in a box,” the centers offer walk-in medical services and extended hours to customers with sore throats, ear infections, sprained or fractured limbs, simple wounds and other non-life-threatening medical problems. Doctors provide the care, assisted by nurses, and generally X-ray and laboratory services are available. Most centers are open 365 days a year, and insurance policies cover most services.

This convenience-oriented format, started more than 20 years ago, is getting a boost as hospitals and private firms build new centers, responding in part to new competition from retail clinics in Walgreens, CVS and Wal-Mart stores.

For patients, the centers offer easy access and affordable care, charging a fraction of what services would cost in an emergency room. Many insurers, keen to keep costs down, have begun encouraging people to use urgent care as an alternative to ERs in the evenings or weekends when their doctors’ offices are closed.

That puts the onus on patients to evaluate their symptoms and recognize what level of care they need, said Dr. Sandra Schneider, an emergency-department physician at the University of Rochester Medical Center in New York and a vice president of the American College of Emergency Physicians.

Generally, urgent care is for common medical conditions only. Symptoms that warrant a visit to the ER include difficulty breathing, fainting, sudden dizziness, changes in mental status, severe or persistent vomiting or diarrhea, uncontrolled bleeding, changes in vision, and pain or pressure in the chest or upper abdomen, according to materials on the topic prepared by Edward Hospital in Naperville.

In Illinois and most other states, urgent-care centers are not overseen by the Department of Health or other state agencies. Some centers have sought out accreditation, a mark of professional approval, but many haven’t. Patients would be well advised to check out in advance the scope of a center’s services, the credentials of its staff and the hours of operation, Schneider recommended.

For families with young children, parents should call to find out if a center offers pediatric care and, if so, whether it treats babies and infants, said Lou Ellen Horwitz, executive director of the Urgent Care Association of America, a trade organization with offices in Warrenville. The association is drafting a list of criteria that will let consumers know what to expect from an urgent-care center and taking steps to improve professional training for staff.

In a comprehensive 2008 survey, it counted 8,000 urgent-care centers across the country. The vast majority are owned by physicians; about 15 percent are associated with hospitals. Although 1 in 4 centers serves an urban population, the majority — 55 percent — are in the suburbs, where affluent and privately insured patients often are reluctant to spend hours waiting to be seen in an ER.

The survey found that about 60 percent of patients at urgent-care centers are seen by a doctor, nurse practitioner or physician’s assistant in 30 minutes or less, another 25 percent are seen in 30 to 45 minutes, and 15 percent spend 45 minutes or longer.

In Illinois, the facilities are usually called immediate- or convenient-care centers because a state law doesn’t allow them to use “urgent” in their names. (That designation belonged more appropriately to hospitals, lawmakers thought.) A check shows relatively few immediate-care centers are in the city of Chicago; most are in the suburbs, and more are on the way.

Hospitals here are building facilities to ease pressure on their emergency rooms and enhance patients’ access to non-emergency care. Several for-profit firms that specialize in this health-care niche also have an increasingly large presence.

At Edward’s three centers, including one that opened last year in Oswego, visits exceed 50,000 a year. “If we had to take care of those patients in our ER, we’d be absolutely overwhelmed,” said Brian Davis, vice president of marketing.

Read the rest of the Trib article

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