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2014 ACEP URGENT CARE POLL
RESULTS
PREPARED FOR:
PREPARED BY:
625 North Washington Street, Suite 450
Alexandria, VA 22314
800.644.6646 toll free
703.739.1000 telephone
703.549.6057 fax
www.MarketingGeneral.com
© 2014 Marketing General Incorporated
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 1
Table of Contents
Study Background ...................................................................................................................................... 2
Sample Characteristics ............................................................................................................................... 3
Findings ........................................................................................................................................................ 8
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 2
Study Background
This survey is designed to capture a snapshot of the current trends in emergency medicine.
Invitations to participate were sent on September 1, 2014, to a list of 26,900 current ACEP
members.
Of the 26,900 email invitations sent, 1,382 emails bounced, resulting in a net total of 25,518 sent
invitations. To boost response rates, a reminder email was sent to non-responders and non-
completers on September 4th
. A final reminder email was sent the morning the survey closed on
September 8th
.
The survey officially closed on September 8th
at 11:59 p.m. EDT. Those respondents who
indicated they only worked at an urgent care center were terminated from the study, as they were
unable to answer the majority of the questions that asked about emergency departments.
Therefore, a total of 2,853 surveys were completed, providing a response rate of approximately
11% and a margin of error of 1.8%. The margin of error, or standard error, is a statistical term
used to measure the random fluctuations inherent in samples; the smaller the standard of error,
the more accurate the measurement of the population or universe.
This study’s significance level of .05 carries with it a 95 percent confidence interval. The
confidence interval is established as the likelihood that the same results would be achieved in a
similar study, meaning that if we were to conduct this study 100 times, the same results plus or
minus the margin of error (1.8%) would occur 95 out of 100 times.
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 3
Sample Characteristics
Number of Responses per State
STATE COUNT PERCENT STATE COUNT PERCENT
Alabama 33 1% Missouri 54 2%
Alaska 11 -- Montana 8 --
APO AE 2 -- Nebraska 16 1%
Arizona 52 2% Nevada 11 --
Arkansas 10 -- New Hampshire 23 1%
California 230 8% New Jersey 74 3%
Colorado 66 2% New Mexico 21 1%
Connecticut 47 2% New York 214 8%
Delaware 20 1% North Carolina 89 3%
District of Columbia 9 -- North Dakota 3 --
Florida 123 4% Ohio 123 4%
Georgia 73 3% Oklahoma 25 1%
Guam 1 -- Oregon 56 2%
Hawaii 10 -- Pennsylvania 177 6%
Idaho 12 -- Puerto Rico 5 --
Illinois 131 5% Rhode Island 25 1%
Indiana 53 2% South Carolina 43 2%
Iowa 21 1% South Dakota 7 --
Kansas 17 1% Tennessee 30 1%
Kentucky 31 1% Texas 205 7%
Louisiana 33 1% Utah 29 1%
Maine 19 1% Vermont 8 --
Maryland 67 2% Virginia 89 3%
Massachusetts 71 3% Washington 90 3%
Michigan 136 5% West Virginia 9 --
Minnesota 60 2% Wisconsin 60 2%
Mississippi 17 1% Wyoming 4 --
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 4
Top 11 Participating States
STATE COUNT PERCENT
1. California 230 8%
2. New York 214 8%
3. Texas 205 7%
4. Pennsylvania 177 6%
5. Michigan 136 5%
6. Illinois 131 5%
7. Florida 123 4%
8. Ohio 123 4%
9. Washington 90 3%
10. North Carolina 89 3%
11. Virginia 89 3%
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 5
1. What is the emergency department patient volume where you work the majority of
your time?
About 41% of respondents work in emergency departments with up to 50,000 patients. 44% of
respondents work in facilities with a patient volume between 50,001 and 100,000. The largest
percentage of participants (25%) report working in an emergency department with a patient
volume between 50,001 to 75,000.
4%
1%
0%
1%
9%
19%
25%
12%
12%
9%
6%
2%
0% 5% 10% 15% 20% 25% 30%
Work only at an urgent care center
Not sure
More than 200,000
151,000-200,000
100,001-150,000
75,001-100,000
50,001-75,000
40,001-50,000
30,001-40,000
20,001-30,000
10,001-20,000
Up to 10,000
n = 2,853
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 6
2. Are you involved in any way (e.g., ownership, management, staff, etc.) with urgent
care centers?
A large majority of respondents (82%) report that they are not involved in urgent care centers
in any way.
18%
82%
Yes
No
n = 2,812
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 7
3. In what type of geographic area is your emergency department located?
Nearly one half of participants (47%) indicate that they work in an urban emergency
department.
47%
40%
13%
Urban
Suburban
Rural
n = 2,744
n =2,744
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 8
Findings
4. What percentage of patients in your emergency department are self-pay?
41% of respondents report that approximately 11% to 25% of patients are self-pay.
22%
1%
1%
3%
15%
41%
17%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Not sure
None
More than 75%
51-75%
26-50%
11-25%
Up to 10%
n = 2,738
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 9
5. What percentage of patients in your emergency department are Medicaid recipients?
About one third of respondents (34%) indicate that between 11% and 25% of their patients
receive Medicaid. Further, 28% report that 26%-50% of patients in their emergency department
are Medicaid recipients.
24%
1%
1%
6%
28%
34%
6%
0% 5% 10% 15% 20% 25% 30% 35% 40%
Not sure
None
More than 75%
51-75%
26-50%
11-25%
Up to 10%
n = 2,738
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 10
6. In the past year, has at least one urgent care center or more operated within 10 miles
of your emergency department?
86% of participants report that at least one urgent care center operates within 10 miles of their
emergency department, with 76% indicating more than one in operation.
10%
76%
7%
8%
Yes, only one
Yes, more than one
No
Not suren = 2,745
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 11
7. In the past year, has the number of visits to your emergency department been
affected by an urgent care center operating within 10 miles of your emergency
department?
Over one-third of respondents (37%) have noticed a change in the number of patients visiting
the emergency department as a result of a local urgent care center. 21% have reported a
decline in emergency visits while 16% have reported an increase in emergency visits. 39% of
respondents indicate that over the last year there has been no change in the number of visits to
their emergency department due to an urgent care center operating within 10 miles.
21%
16%
39%
24%
Yes, emergency visits have decreased
Yes, emergency visits have increased
No, there has been no change
Not suren = 2,342
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 12
8. In your opinion, how is the growth in urgent care centers affecting the use of health
care resources (such as physician visits, medical tests, procedures, etc.)?
40% of participants indicate that there has been an increase in the use of health care resources
due to the growth in urgent care centers, while 22% report that there has been no change in
the use of health care resources.
40%
9%
22%
29%
Increasing use of health care resources
Decreasing use of health care resources
No change in use of health care resources
Not sure
n = 2,659
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 13
9. Has the growth of urgent care centers caused a change in the types of patients you
see?
43% of respondents indicate that the growth of urgent care centers has not caused a change in
the types of patients they see, while 29% report that they have seen only a little change in the
types of patients seen.
15%
29%
43%
14%
Yes, significant change
Yes, little change
No change
Not suren = 2,556
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 14
10. How have your patients changed as a result of the growth in urgent care centers?
Check all that apply.
An overwhelming majority of respondents (77%) report that the main change due to the
growth in urgent care centers is that they see patients with more complicated issues. 54%
report their patients are less insured, and 53% say that their patients have a lower income.
6%
1%
2%
3%
4%
39%
53%
54%
77%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Other
Higher income
More insured
Less complicated issues
Younger
Older
Lower income
Less insured
More complicated issues
n = 1,090
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 15
11. Will urgent care centers pull more patients from emergency care or primary care?
Just over half of participants (51%) indicate that urgent care centers will pull patients from both
emergency care and primary care, while nearly a quarter of respondents (22%) report that
urgent care centers will pull more patients from primary care.
8%
6%
13%
22%
51%
0% 10% 20% 30% 40% 50% 60%
Not sure
Neither
Emergency care
Primary care
Both
n = 2,663
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 16
12. Are urgent care centers in your area marketing themselves as alternatives to the
emergency department?
More than half the participants (54%) report that urgent care centers in their area are
marketing themselves as alternatives to the emergency department. 21% indicate that only
some of the urgent care centers are doing so.
54%
21%
15%
10%
YesSome, but not allNoNot sure
n = 2,659
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 17
13. Should urgent care centers be subject to EMTALA regulations?
Nearly half of respondents (49%) indicate that urgent care centers should be subject to EMTALA
regulations, while 39% disagree.
49%
39%
12%
Yes
NoNot sure
n = 2,661
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 18
14. Should states have specific staffing or equipment criteria for urgent care centers?
A large majority of participants (72%) believe that states should have specific staffing or equipment criteria for urgent care centers. 18% of respondents, however, do not think states should have such criteria for urgent care centers.
72%
18%
9%
1%
Yes
No
Not sure
n = 2,662
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 19
15. How often are patients referred to your emergency department from an urgent care
facility?
Over half the participants (54%) report that patients are referred to their emergency
department from urgent care centers more than once a day. Only 1% of respondents indicate
that patients are never referred to their emergency department from an urgent care center.
5%
1%
1%
4%
19%
17%
54%
0% 10% 20% 30% 40% 50% 60%
Not sure
Never
Once or twice a year
Once or twice a month
Once or twice a week
Once a day
More than once in a day
n = 2,556
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 20
16. What are the primary reasons that patients are redirected to an emergency
department from an urgent care facility? (Select top 2 reasons.)
A vast majority of participants (90%) report that patients were redirected to the emergency
department because the medical condition was potentially more serious than the patient
thought. Further, 65% indicate that the patient was redirected to the emergency department
from the urgent care center because of the limited equipment and staffing at the urgent care
center.
6%
3%
14%
65%
90%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Other (please specify)
Could not get a timely appointment
Did not have appropriate insurance or ability to payat time of urgent care visit
Limited equipment and staffing compared toemergency department
Medical condition was potentially more serious thanpatient thought
n = 2,623
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 21
17. Of your patients who could have been safely treated at an urgent care center, why did
they choose to go to the emergency room? (Select top 2 reasons.)
According to 44% of respondents, patients chose to go to the emergency department although
they could have been safely treated at an urgent care center because of a lack of appropriate
insurance or inability to pay the urgent care center. One third of participants (33%) also say that
another primary reason is that the patient thought the emergency room was a better option.
4%
14%
19%
21%
22%
31%
33%
44%
0% 10% 20% 30% 40% 50%
Other (please specify)
Perception that the quality of care at emergency room issafer
Unfamiliarity with urgent care centers
Could not get in to see a physician in a timely manner(either appointment or walk-in)
Urgent care center was closed
Patients thought symptoms indicated a medical emergency
Patient thought emergency room was a better option totake care of them
Did not have appropriate insurance or ability to pay urgentcare center
n = 2,494
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 22
18. Are urgent care centers in your area staffed by physicians on site?
44% of participants indicate that some of the urgent care centers in their area are staffed by
physicians on site, but not all of them are. Moreover, 40% report that all the urgent care
centers in their area are staffed by physicians on site.
5%
10%
40%
44%
No
Not sure
Yes
Some, but not all
n = 2,654
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 23
19. Do urgent care centers in your area have access to on-call specialists?
Just over one third of participants (35%) indicate that the urgent care centers in their area do
not have access to on-call specialists. However, 22% of respondents report that some urgent
care centers do have access to such specialists, while 9% say the urgent care centers in their
area do have access to on-call specialists.
9%
22%
34%
35%
Yes
Some, but not all
Not sure
No
n = 2,659
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 24
20. Do urgent care centers in your area take Medicaid?
Only 14% of respondents indicate that urgent care centers in their area take Medicaid, while
21% say that some urgent care centers do, but not all of them. 19% of participants say that
urgent care centers in their area do not take Medicaid.
14%
19%
21%
46% YesNoSome, but not allNot sure
n = 2,658
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 25
21. Do urgent care centers in your area have a triage process?
Only 20% of respondents indicate that the urgent care centers in their area have a triage
process. 13% of participants report that urgent care centers near them do not have a triage
process. Only 4% say that triage is not needed at the urgent care centers in their area.
20%
13%
4%
63%
YesNoTriage not neededNot sure
n = 2,658
n = 2,655
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 26
22. How many patients would you estimate your emergency department treated in the
past year that first went to urgent care centers for life-threatening conditions (e.g.,
chest pain, stroke symptoms, difficulty breathing, etc.), instead of going directly to the
emergency room?
About 30% of respondents report that over the past year their emergency department has
treated up to 100 patients who originally went to urgent care centers for life-threatening
conditions, and close to one-quarter (23%) indicate that 101 – 400 were patients who originally
went to an urgent care center were treated in their emergency department for a life-
threatening condition. 9% of respondents report their emergency department had more than
1,000 patients who originally went to an urgent care center for a life-threatening condition.
25%
1%
9%
8%
4%
7%
7%
9%
6%
5%
8%
11%
0% 5% 10% 15% 20% 25% 30%
Not sure
None
More than 1,000
501-1,000
401-500
301-400
201-300
101-200
76-100
51-75
26-50
1-25
n = 2,537
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 27
23. How concerned are you that patients with serious medical conditions may go to
urgent care centers first before going to the emergency department?
A total of 76% of participants indicate that they have at least some concern about patients with
serious medical conditions going to an urgent care center before going to the emergency
department. Less than one quarter of participants (23%) say that they are not at all concerned.
20%
56%
23%
2%
Very concerned
Somewhat concerned
Not at all concerned
Not sure
n = 2,647
2014 ACEP Urgent Care Poll Results
Marketing General Incorporated | 625 N. Washington Street | Suite 450 | Alexandria, VA 22314 | p: 703.739.1000
Page 28
24. What percentage of patients can determine for themselves whether or not they
require emergency care?
Nearly one quarter of participants (24%) indicate that between 11% and 25% of patients can
determine for themselves whether they require emergency care. Moreover, 24% of
respondents believe that between 26% and 50% of patients can determine for themselves if
they need emergency care.
11%
3%
8%
13%
24%
24%
18%
0% 5% 10% 15% 20% 25% 30%
Not sure
No patients
More than 75%
51-75%
26-50%
11-25%
Up to 10%
n = 2,651