'Urgent care' would help save €60m

A MODEL OF healthcare which has saved the US billions of dollars in costs could lessen the burden on accident and emergency departments here, a conference in Dublin has heard.

Dr Lee Resnick said the growth of 8,000 urgent care centres in the US over the past 30 years had reduced the strain on AE departments in America, saving $8 billion-$12 billion a year (€6.3 billion-€9.4 billion) annually.

The equivalent figure here would be €60 million-€100 million.

Urgent care centres are walk-in centres for patients who do not need emergency treatment. That includes people with flu-like symptoms, diarrhoea, respiratory problems and fractures which are not life threatening.

Dr Resnick, who is the president of the Urgent Care Association of America, said emergency departments should be used only for emergency treatments such as severe trauma injuries, yet they are often overwhelmed by cases which are less urgent in nature.

He said the problem was universal, even in the United States where 40 per cent of all emergency department visits were still deemed semi-urgent or urgent despite the presence of thousands of alternative facilities.

"The same conditions apply to the US as they do in Ireland. Emergency departments tend to have trouble accommodating the acute care needs of the population that are non-emergent in nature," he said.

"These cases can be managed in a timely convenient and cost-effective manner which do not unnecessarily clog up a country's accident and emergency departments and distracts them from caring for the critical patient which is their primary function," he said.

Dr Resnick was the keynote speaker at the VHI SwiftCare Clinic International urgent medical care seminar in Dublin at the weekend.

The SwiftCare clinics are based on the American urgent care model and were founded nearly three years - the first one being located opposite the Dundrum Town Centre. Others are located at Dublin City University, Airside Retail Park, Swords, Whitfield Clinic in Waterford and at City Gate in Mahon, Cork.

They charge €105 for an initial consultation - the same as is now being charged for a visit to a public AE department. The SwiftCare clinics also charge fees of €30-€50 for a blood test, €50-€75 for stitches and €55 for putting a limb in plaster.

Dr Resnick said such clinics were ideal for dealing with non-emergency cases.

"It is exactly the model as far as we're concerned. They see patients entirely on a walk-in basis, they care for the full spectrum of minor injuries and illnesses with the capability of initial management and transfer of a sicker patient.

"They are working closely with their GP colleagues in assisting them in their management of patients if they have an acute care need that cannot be managed by them for whatever reason," he said.

He believes the urgent care model is as applicable for the public health system as it is for patients in a private setting.

"At the end of the day the cost of healthcare delivery has to be assessed. Whether it comes out of the public or private pocket, it is really the same pocket ultimately," he said.

Dr Resnick said the €105 charge for using AE departments did not cover the full costs of treating patients there. AE departments have costs which add a multiple on to the cost of treating patients who could be dealt with in an urgent care environment.

Those include wages for consultants and nurses, round-theclock opening, specialist equipment and the space needed to operate such facilities.

"We've done studies that have examined the very question. What is the differential cost of care between an urgent care clinic and an AE department and the multiples are three to four times.

"The total overheads are significantly higher. There is an argument to be made that total healthcare costs will be diminished if more emphasis is put on urgent care clinics."