Health care utilization and outcomes of patients seen by virtual urgent care versus in-person emergency department care

Abstract

Background: Virtual urgent care (VUC) is patients in each cohort to an equal who were seen by a VUC provider with no intended to support diversion of patients number of patients presenting to an documented referral to the emergency with low-acuity complaints and reduce emergency department in person, department. Patients seen by VUC were the need for in-person emergency depart- based on encounter date, medical con- more likely to have a subsequent in-ment visits. We aimed to describe subse- cern and the logit of a propensity score. person emergency department visit quent health care utilization and out- For the subgroup of patients not within 72 hours (13.7% v. 7.0%), 7 days comes of patients who used VUC promptly referred to an emergency (16.5% v. 10.3%) and 30 days (21.9% v. compared with similar patients who had department, we matched patients to 17.9%), but hospital admissions were an in-person emergency department visit. those who were seen in an emergency similar within 72 hours (1.1% v. 1.3%), department and then discharged home. and higher within 30 days for patients Methods: We used patient-level who were discharged home from the encounter data that were prospectively Results: Of the 19595 patient VUC visits emergency department (2.6% v. 3.4%). collected for patients using VUC services linked to administrative data, we provided by 14 pilot programs in matched 2129 patients promptly referred Interpretation: The impact of the prov-Ontario, Canada. We linked the data to to the emergency department by a VUC incial VUC pilot program on subsequent provincial administrative databases to provider to patients presenting to the health care utilization was limited. identify subsequent 30-day health care emergency department in person. Index There is a need to better understand the utilization and outcomes. We defined visit hospital admissions (9.4% v. 8.7%), inherent limitations of virtual care and 2 subgroups of VUC users; those with a 30-day emergency department visits ensure future virtual providers have documented prompt referral to an (17.0% v. 17.5%), and hospital admissions timely access to in-person outpatient emergency department by a VUC pro- (12.9% v. 11.0%) were similar between resources, to prevent subsequent emervider, and those without. We matched the groups. We matched 14179 patients gency department visits.