High reliance on urgent care centers may disrupt primary care in children

A study of over 4 million children and adolescents in the U.S. enrolled in Medicaid found that those who rely on urgent care centers for more than a third of their outpatient health care needs had fewer visits to primary care providers. This may result in missed opportunities for preventative services, such as vaccinations, and identification and management of chronic conditions, such as obesity or asthma. Findings were published in JAMA Network Open.

"Routine well-child care plays an essential role in ensuring children's optimal growth and development," says lead author Rebecca Burns, MD, Medical Director of Urgent Care at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor in Pediatrics at Northwestern University Feinberg School of Medicine. "While urgent care facilities may serve to increase access for acute care needs, high reliance on these facilities could have the unintended consequence of displacing important services that children receive in regular primary care settings. If this were to occur, it could lead to concerning health impacts down the road."

The American Academy of Pediatrics recommends multiple well-child care visits per year for children younger than 3 years of age and yearly primary care visits for older children and adolescents. Urgent care sites are a growing option for patients to address acute healthcare needs, including low-acuity illnesses and injuries. The number of these sites has increased from nearly 7,000 in 2015 to over 9,000 in 2019.

In their study, Dr. Burns and colleagues found that high reliance on urgent care centers was associated with age, race and presence of chronic conditions. Children 6-12 years of age were more likely to have high reliance on urgent care compared with adolescents (13-18 years of age). White children had the highest reliance on urgent care compared to black or Latino children. Children with chronic conditions were less likely to have high reliance on urgent care for their healthcare needs.

"Our study did not differentiate between the types of urgent care centers that were used," says Dr. Burns. "Urgent care centers operating within a particular healthcare system may allow urgent care providers to access the patient's medical record and facilitate communication with the primary care provider, which can make a big difference in ensuring continuity of care. We need further research to understand the factors contributing to a high reliance on urgent care and to assess the impact that this reliance may have on a child's relationship with their medical home."