Access Type

Open Access Dissertation

Date of Award

January 2024

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Economics

First Advisor

Shooshan Danagoulian

Second Advisor

Allen C. Goodman

Abstract

This dissertation examines aspects of the urgent care market. We first explore the history and recent trends of urgent care, from its inception in the 1970 to its growing competition with primary care physicians and retail clinics in the 2010s. We examine aspects of how urgent care can impact a patient’s medical home and its use of pricing transparency that is sweeping the nation. We examine the growing need for patient convenience and flexibility in care with retail clinics encroaching the urgent care service space. We also cover the development of technology to better facility telehealth visits and to disrupt the traditional forms of medical care delivery. We then examine where urgent care centers are located using data from National Urgent Care Realty, controlling for socioeconomic and medical provider factors and proximity. We examine both site-specific and neighborhood characteristics at county and census tract levels. Our results indicate a strong location dependent relationship with local emergency departments, private health insurance, and similar-in-service limited urgent cares. At the county level, urgent care centers cluster in high population areas but tend to avoid direct competition with other urgent care centers and distinct differences in placement among affiliated and non-affiliated urgent care providers. Finally, we examine the impact medical providers have on urgent care center visits in Michigan metropolitan areas during the onset of the pandemic using foot-traffic Patterns data from SafeGraph. We first establish a patient catchment area based on a provider centric approach to each medical provider, then control for either market concentration or public medical access. We find that urgent care centers experienced a 21% decline in visits during the first three month of the pandemic. We also find evidence of medical providers benefiting being within areas with low market concentration and high public access to medical care. Urgent care centers have an asymmetric substitution effect between hospitals. Spillover and siphoning effect are present as medical providers rely on the presence and knowledge of other developers to develop patient volume, seen in the popularity of medical malls.

Included in

Economics Commons

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