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Substituting Hospitals: An Analysis of Urgent Care Centers in the Market for Healthcare

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The primary purpose of this paper is to analyze urgent care centers and explain their role within the U.S. healthcare system. The introduction of urgent care into the market for health care services has brought with it a new way for consumers to receive non-emergent healthcare outside of traditional hours.…

The primary purpose of this paper is to analyze urgent care centers and explain their role within the U.S. healthcare system. The introduction of urgent care into the market for health care services has brought with it a new way for consumers to receive non-emergent healthcare outside of traditional hours. Urgent care is often cited as a plausible alternative to care received at an emergency department or primary care physician's office. One of the key questions the author attempts to answer is: "To what degree are urgent care centers an economic substitute to emergency departments or physician's offices?" This paper looks at both projected demand from currently operating urgent care centers and consumer preference surveys to estimate the willingness of consumers to use urgent care. The method used to accomplish this task has been compiling scholarly research and data on urgent care centers. After a thorough examination of relevant studies and datasets, urgent care centers have been found to be just as preferred as emergency departments when considering non-emergent cases, specifically among individuals aged 18-44. The clear majority of consumers still prefer visiting a primary care physician over an urgent care center when it comes to episodic care, however. When taking into account wait times, differences in cost, and ease of access, urgent care becomes much more preferred than an emergency department and weakly preferred to a physician's office. There are still some concerns with urgent care, however. Questions of capacity to meet demand, access for underserved communities, and susceptibility to adverse selection have yet to be fully explored.
ContributorsBullington, Robert Heyburn (Author) / Foster, William (Thesis director) / Hill, John (Committee member) / Sandra Day O'Connor College of Law (Contributor) / W.P. Carey School of Business (Contributor) / Department of Economics (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Time Spent Discussing Pharmacological Interventions Among Different Primary Care Providers

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Despite differences in schooling and clinical experience prior to practice, advanced practice providers often have similar scopes of practice, which raises concerns about the quality of care being provided. In this paper, we explore if prescribing patterns are comparable between provider types by comparing differences in time spent on pharmacological…

Despite differences in schooling and clinical experience prior to practice, advanced practice providers often have similar scopes of practice, which raises concerns about the quality of care being provided. In this paper, we explore if prescribing patterns are comparable between provider types by comparing differences in time spent on pharmacological interventions utilizing a simulated healthcare environment. Physicians (MDs and DOs), Nurse Practitioners (NPs), and Physician Assistants (PAs) actively practicing in Family Practice/Medicine or Internal Medicine in the U.S. state license/recognition were recruited at healthcare conferences and simulation centers. Participants were provided 20 minutes to complete the patient consultation on a Standardized Patient (SP) presenting with a chief complaint of a post-hospitalization follow-up for heart failure, fatigue, and some edema. All encounters were recorded and uploaded to be reviewed by undergraduate evaluators, who were responsible for quantifying the amount of time the participants spent on each of the task categories, including pharmacologic interventions. With a total of 46 participants in this study, the average amount of time spent discussing this activity per visit across each provider type was 14.8 seconds for MDs/DOs, 29.2 seconds for NPs, and 38.8 seconds for PAs. The results of this study suggest that PAs (p= 0.0028) spent significantly more time discussing pharmacological interventions and were significantly more likely to discuss pharmacological interventions (p=0.0243) when compared with physicians (MD/DOs). It is important to note that the sample size of PAs was very small (N=9), which could potentially skew the results and not be representative of the population. With limited literature that examines whether time spent discussing pharmacological interventions is comparable across provider types, it is important for more simulated healthcare research to be conducted on this topic.
ContributorsParedes, Addlena (Author) / Seifert, Sabrina (Co-author) / Green, Ellen (Thesis director) / Reifsnider, Elizabeth (Committee member) / Barrett, The Honors College (Contributor)
Created2023-05
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Behavioral Health Integration in Primary Care: A Systematic Review

Description
The integration of behavioral health services into primary care in a rapidly evolving innovation that has shown potential to improve access to care, health outcomes, and lower health costs. In an effort to reform healthcare system, integrating behavioral health services become a vital part of the patient-centered medical home (PCMH).…

The integration of behavioral health services into primary care in a rapidly evolving innovation that has shown potential to improve access to care, health outcomes, and lower health costs. In an effort to reform healthcare system, integrating behavioral health services become a vital part of the patient-centered medical home (PCMH). As research and developments in integration continue to evolve, there is a need to identify consistencies, discrepancies, and gaps in the field to inform the best ways to move forward. This study is a systematic review seeking to identify trends, gaps, and future directions of research in integrated behavioral health in primary care. Using Google Scholar 171 papers were included, 95 being original research and 76 being reviews, commentary, and editorials. From the results, it is clear that the case for integration has been made, and now it is time to move to the specifics. Both empirical and theoretical evidence supports the benefits of integration to patients and health systems. However, there is a lack of literature that tackles problems that hinder or facilitate integration in independent clinics with unique characteristics. Most notably, specific interventions that are effective and appropriate in primary care, payment reforms that are feasible and sustainable, and the effect of integration on health disparities.
ContributorsDye- Robinson, Amy (Author) / Kessler, Rodger (Thesis director) / McEntee, Mindy (Committee member) / School of Molecular Sciences (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-12
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Mitigating Noncompliance in Medical Practice: A Multi-Frame Analysis and Application to Improve Patient Outcomes in the Private Primary Care Setting

Description
The healthcare industry within the United States is divided into the private and public sectors. Medical care is provided through an extensive network of subspecialist practitioners. The most common type of medical practice and one most utilized by patients is primary care, with 51.2% of all medical office visits made…

The healthcare industry within the United States is divided into the private and public sectors. Medical care is provided through an extensive network of subspecialist practitioners. The most common type of medical practice and one most utilized by patients is primary care, with 51.2% of all medical office visits made to primary care practices in 2018 (CDC, 2018). This scope of medicine is most frequently responsible for the initial diagnoses and treatment plans of diseases. This thesis project begins with a description of the roles of primary practice in the broader scope of the medical field, and details why primary care is essential in keeping populations healthy. It moves to discuss a local example of a private primary care practice, AllCare Internal Medicine, and describes the organization’s structure and function. Medical noncompliance, a pressing issue at this facility and in the entirety of the medical field, is introduced and explained using industry research. Medical noncompliance at AllCare Internal Medicine is then considered in the context of Bolman and Deal’s multi-frame organizational theory. Furthermore, a four-frame analysis of AllCare Internal Medicine is conducted to highlight the impact of each of Bolman and Deal’s organizational frames on the group and its success. With insights gained from the analysis, a detailed plan for reducing noncompliant behavior is provided for medical staff that focuses on improving interactions with patients. The thesis project concludes with a brief reflection on Bolman and Deal’s organizational frames in the AllCare Internal Medicine setting, as well as provides an explanation of how the plan of action will be successful in reducing noncompliance within the practice.
ContributorsCarcione, Tanner (Author) / deLusé, Stephanie (Thesis director) / Gerace, Kathleen (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2022-05