Emergency department (ED) characteristics and health care utilization for virtual urgent care prompt referrals who presented to ED within 72 hours versus matched in-person controls
| Variable | No. (%)* patients referred to ED by VUC n = 2129 | No. (%)* of control patients who presented in person to ED n = 2129 | Δ, %* (95% CI) |
|---|---|---|---|
| Arrival by ambulance | 62 (2.9) | 204 (9.6) | −6.7 (−8.1 to −5.2) |
| Acuity score | |||
| Resuscitation (CTAS 1) | 11 (0.5) | 11–15§ | NA |
| Emergent (CTAS 2) | 365 (17.1) | 423 (19.9) | −2.8 (−5.1 to −0.4) |
| Urgent (CTAS 3) | 1242 (58.3) | 1161 (54.5) | 3.8 (0.9 to 6.8) |
| Less urgent (CTAS 4) | 402 (18.9) | 417 (19.6) | −0.7 (−3.1 to 1.7) |
| Nonurgent (CTAS 5) | 109 (5.1) | 114 (5.3) | −0.2 (−1.6 to 1.1) |
| Unknown | 0 (0.0) | 1–5§ | NA |
| Top 5 CEDIS complaints | |||
| Other (not top 5) | 1427 (67.0) | 1423 (66.8) | 0.2 (−3.0 to 2.6) |
| Abdominal pain | 234 (11.0) | 240 (11.3) | −0.3 (−2.2 to 1.6) |
| Fever | 210 (9.9) | 204 (9.6) | 0.3 (−2.1 to 1.5) |
| Upper extremity injury | 107 (5.0) | 108 (5.1) | −0.1 (−1.4 to 1.3) |
| Lower extremity injury | 81 (3.8) | 76 (3.6) | 0.2 (−0.9 to 1.4) |
| Lower extremity pain | 70 (3.3) | 78 (3.7) | −0.4 (−1.5 to 0.7) |
| Procedures† | |||
| No procedures | 173 (8.1) | 99 (4.6) | 3.5 (2.0 to 5.0) |
| Diagnostic only | 97 (4.6) | 32 (1.5) | 3.1 (2.0 to 4.1) |
| Laboratory only | 0 (0.0) | 1–5§ | NA |
| Laboratory, therapeutic and diagnostic | 25 (1.2) | 22 (1.0) | 0.2 (−0.8 to 0.5) |
| Therapeutic only | 817 (38.4) | 1045 (49.1) | −10.7 (−13.7 to −7.7) |
| Therapeutic and diagnostic | 1017 (47.8) | 931 (43.7) | 4.1 (1.0 to 7.0) |
| Top 5 discharge diagnosis | |||
| Other (not top 5) | 1766 (82.9) | 1807 (84.9) | −2.0 (−4.9 to 0.3) |
| Other and unspecified abdominal pain | 94 (4.4) | 88 (4.1) | 0.3 (−1.5 to 0.9) |
| Fever, unspecified | 84 (3.9) | 71 (3.3) | 0.6 (−0.5 to 1.7) |
| Urinary tract infection, site not specified | 61 (2.9) | 64 (3.0) | −0.1 (−0.9 to 1.2) |
| Chest pain, unspecified | 72 (3.4) | 47 (2.2) | 1.2 (0.2 to 2.2) |
| COVID-19 | 52 (2.4) | 52 (2.4) | 0.0 (−0.9 to 0.9) |
| Discharge disposition | |||
| Missing | 11 (0.5) | 20 (0.9) | −0.4 (−0.9 to 0.1) |
| Admitted | 201 (9.4) | 186 (8.7) | 0.7 (−1.0 to 2.4) |
| Discharged | 1902 (89.3) | 1909 (89.7) | −0.4 (−2.2 to 1.5) |
| Transferred | 15 (0.7) | 14 (0.7) | 0.0 (−0.5 to 0.5) |
| ED visit, in-person | |||
| Within 72 h of index visit | 149 (7.0) | 166 (7.8) | −0.8 (−2.4 to 0.8) |
| Within 7 d of index visit | 207 (9.7) | 225 (10.6) | −0.9 (−2.7 to 1.0) |
| Within 30 d of index visit | 362 (17.0) | 372 (17.5) | −0.5 (−2.7 to 1.8) |
| VUC visit | |||
| Within 72 h of index visit | 51 (2.4) | 0 (0.0) | 2.4 (1.8 to 3.1) |
| Within 7 d of index visit | 81 (3.8) | 0 (0.0) | 3.8 (3.1 to 4.7) |
| Within 30 d of index visit | 142 (6.7) | 0 (0.0) | 6.7 (5.7 to 7.8) |
| Hospital admission | |||
| Within 72 h of index visit | 224 (10.5) | 200 (9.4) | 1.1 (−0.7 to 2.9) |
| Within 7 d of index visit | 241 (11.3) | 215 (10.1) | 1.2 (−0.6 to 3.1) |
| Within 30 d of index visit | 274 (12.9) | 234 (11.0) | 1.9 (−0.1 to 3.8) |
| Length of stay, d, mean ± SD | 7.5 ± 17.5 | 5.1 ± 6.0 | 2.4 (1.6 to 3.2) |
| Primary care visits | |||
| Visit on same day as index visit‡ | 654 (30.7) | 248 (11.6) | 19.1 (16.7 to 21.5) |
| Within 7 d of index visit (excluding index date) | 523 (24.6) | 498 (23.4) | 1.2 (−1.4 to 3.7) |
| Within 30 d of index visit (excluding index date) | 979 (46.0) | 938 (44.1) | 1.9 (−1.1 to 4.9) |
| Specialist visits | |||
| Visit on same day as index visit‡ | 631 (29.6) | 95 (4.5) | 25.1 (23.0 to 27.3) |
| Within 7 d of index visit (excluding index date) | 512 (24.0) | 373 (17.5) | 6.5 (4.1 to 9.0) |
| Within 30 d of index visit (excluding index date) | 1035 (48.6) | 794 (37.3) | 11.3 (8.4 to 14.3) |
Note: CTAS = Canadian Triage and Acuity Scale, CEDIS = Canadian Emergency Department Information System, CI = confidence interval, NA = not applicable, SD = standard deviation, VUC = virtual urgent care.
↵* Unless otherwise specified.
↵† Diagnostic refers to investigations such as diagnostic imaging or performing an electrocardiogram. Therapeutic refers to a procedure having been done or medication administered.
↵‡ For patients who saw a primary care provider or specialist on the same day as the VUC visit, it is not known which occurred first.
↵§ Data in cells are suppressed to protect patient privacy.