This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hampers, L. C.
Right arrow Articles by Poole, S. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hampers, L. C.
Right arrow Articles by Poole, S. R.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 110 No. 6 December 2002, pp. 1117-1124

Regional After-Hours Urgent Care Provided by a Tertiary Children’s Hospital

Louis C. Hampers, MD, MBA*, S. Glenn Faries, MD* and Steven R. Poole, MD

Children’s Hospital Pediatric Urgent Care Network
* Section of Pediatric Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado

--> Background. Ambulatory presentation to a tertiary pediatric emergency department (ED) is not convenient for many families. Yet many primary care pediatricians (PCPs) desire after-hours urgent care for their patients as an alternative to extended office hours or care by general emergency medicine providers at community hospitals.

Objective. To describe a regional, community-based pediatric urgent care network (PUCN).

Methods. The PUCN consists of 4 models: 1) pediatric emergency medicine faculty in a community hospital ED; 2) general pediatricians in a community hospital ED; 3) general pediatricians in a freestanding urgent care center; and 4) general pediatricians in a community hospital-based urgent care center. Physician staffing at all 4 sites is managed by our tertiary children’s hospital. Billing records were reviewed and a questionnaire was mailed to 55 PCP practices in our metro area.

Results. Year 2001 visits totaled 37 143. Minor trauma, ear complaints, and viral illnesses accounted for 70% of visits. Current Procedural Terminology codes for visits, reflecting complexity levels 1, 2, 3, 4, and 5 were billed at the following frequency: 1%, 35%, 44%, 17% and 3%, respectively. A total of 2.2% of visits required admission or transfer. Mean collection rates ranged from 37% to 68% across the 4 sites. Break-even average hourly patient volumes ranged from 1.1 (site 4) to 1.9 (sites 1 and 3).

A total of 110 PCPs, representing all 55 practices, responded to the questionnaire: 81% reported their patients used the PUCN often, 85% felt that communication between the PUCN and their practice was good, and 99% reported overall satisfaction with the network.

Conclusions. The PUCN effectively addresses the needs of regional PCPs; however, the cost-effectiveness of such a program depends on billing practices, local collection rates, and site-specific staffing patterns.

Key Words: urgent care • regional network • after-hours

Abbreviations: PCP, primary care provider • TCH, The Children’s Hospital • PUCN, pediatric urgent care network • ED, emergency department • PEM, pediatric emergency medicine • EMS, emergency medical services • GEM, general emergency medicine • EMTALA, Emergency Medical Treatment and Active Labor Act

Received for publication Jan 8, 2002; Accepted May 3, 2002.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?