Hybrid approach to urgent care: a comparison with Low-Acuity urgent care options

Background Global healthcare systems face workforce shortages that disproportionately impact rural communities. A hybrid approach, blending in-person and virtual modalities, offers a scalable solution for resource distribution to hard-to-serve communities. Aim To compare healthcare utilization following hybrid urgent care encounters with traditional low-acuity encounters in primary care, urgent care and emergency departments (EDs). Design & setting A population-level, propensity-score matched, retrospective cohort study using health administrative data from Ontario, Canada. Method Patients who accessed a hybrid approach to urgent care between July 1, 2023, and June 30, 2024, were matched to other Ontario patients accessing care in traditional low-acuity settings. Post-visit outcomes, including ED visits, primary care follow-ups and hospitalizations, were analyzed at 30 days post index encounter. Results A hybrid approach to urgent care was associated with a higher absolute number of post-index encounter healthcare visits, overwhelmingly virtual follow-up encounters. Compared with low-acuity ED visits, hybrid urgent care was associated with lower odds of subsequent ED visits and in-person primary care visits. Among rural residents without a family doctor, hybrid urgent care was associated with 50% lower odds of an ED visit (odds ratio (OR): 0.50; 95% confidence interval (CI): 0.44-0.57), and 53% lower odds of an in-person primary care visit (OR: 0.47; 95% CI: 0.38-0.58) compared with initial low-acuity ED visits. Conclusions By diverting initial and follow-up encounters away from EDs and in-person primary care, a hybrid approach may increase access while shifting healthcare utilization away from strained local ED and primary care services in underserved communities.