Pediatric Emergency Transfers Following Virtual Urgent Care Visits.

Telemedicine use has surged since the COVID-19 pandemic, offering patients access to remote health care and the potential to reduce nonemergent emergency department (ED) visits. This study aims to describe postpandemic virtual urgent care (VUC) utilization, including VUC-to-ED referral rates and outcomes in children. We performed a retrospective cohort study of patients under 21 years presenting to the ED within 72 hours following a VUC visit from March 1, 2021, through February 28, 2023, using the electronic medical record. We reviewed demographic data and examined ED care and disposition for patients VUC physician-referred compared with those who self-referred. We analyzed 4676 completed VUC patient visits. Patients who preferred English, were non-Hispanic, and had commercial insurance were more likely to complete their VUC visit, with a rate of 72%. Among all patients who completed a VUC visit, 5.9% were referred to the ED by a VUC physician with a 19% admission rate, whereas 5% of patients self-referred with a 6% admission rate. On logistic regression analysis, only insurance status was significant; patients with Medicaid had twice the odds of a self-referred visit. This study demonstrated low referral rates from VUC to ED. Despite modifications to improve VUC access, disparities in VUC utilization persist. Patients with Medicaid are more likely to self-refer to the ED, although they have lower rates of admission when self-referred. Future qualitative studies are needed to optimize VUC as an equitable health care resource.