Descriptive statistics, unadjusted and adjusted associations, and absolute risk differences between patient characteristics and urgent care visits transferred to the emergency department (ED) in Ontario, Canada, 1 April 2015 to 31 March 2020
| All urgent care visits, n (%) | Urgent care visits transferred to ED, n (%) | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | Absolute risk % (95% CI)* | |
| Total visits | 1 448 621 | 63 343 | |||
| Visit outcome | |||||
| Discharged | 1 368 323 (94.5) | – | |||
| Transferred to ED | 63 343 (4.4) | 63 343 (100.0) | |||
| Other | 16 995 (1.2) | – | |||
| Sex | |||||
| Male | 617 372 (42.6) | 28 501 (45.0) | Ref | Ref | – |
| Female | 831 249 (57.4) | 34 842 (55.0) | 1.11 (1.09 to 1.12) | 1.18 (1.16 to 1.20) | 0.7 (0.7 to 0.7) |
| Age group, years | |||||
| 18–39 | 546 893 (37.8) | 14 616 (23.1) | Ref | Ref | – |
| 40–64 | 581 833 (40.2) | 23 818 (37.6) | 1.55 (1.52 to 1.59) | 1.38 (1.35 to 1.41) | 1.4 (1.3 to 1.4) |
| 65–105 | 319 895 (22.1) | 24 909 (39.3) | 3.08 (3.01 to 3.14) | 2.29 (2.23 to 2.35) | 4.1 (4.0 to 4.2) |
| Triage, CTAS | |||||
| 1 or 2† | 118 793 (8.2) | 23 823 (37.6) | 26.17 (24.72 to 27.70) | 14.27 (13.45 to 15.12) | 21.2 (20.7 to 21.8) |
| 1 | 1335 (0.1) | 876 (1.4) | – | – | |
| 2 | 117 458 (8.1) | 22 947 (36.2) | – | – | |
| 3 | 546 149 (37.7) | 30 774 (48.6) | 6.22 (5.89 to 6.59) | 4.24 (4.01 to 4.49) | 5.9 (5.8 to 6.1) |
| 4 | 649 273 (44.8) | 7470 (11.8) | 1.21 (1.14 to 1.29) | 1.14 (1.07 to 1.21) | 0.5 (0.3 to 0.8) |
| 5 | 134 406 (9.3) | 1276 (2.0) | Ref | Ref | – |
| Access to primary healthcare | |||||
| Yes | 1 315 978 (90.8) | 58 761 (92.8) | 1.31 (1.27 to 1.35) | 0.99 (0.96 to 1.03) | 0.0 (−0.2 to 0.1) |
| No/unknown | 132 643 (9.2) | 4582 (7.2) | Ref | Ref | – |
| Referral source | |||||
| Self-referred | 1 351 341 (93.3) | 58 879 (93.0) | 0.84 (0.81 to 0.88) | 0.85 (0.81 to 0.89) | −0.7 (−1.0 to −0.5) |
| Ambulatory care service | 49 416 (3.4) | 2001 (3.1) | 0.78 (0.73 to 0.83) | 1.12 (1.05 to 1.20) | 0.5 (0.2 to 0.8) |
| Other | 47 864 (3.3) | 2463 (3.9) | Ref | Ref | – |
| Geographical location | |||||
| Urban | 1 374 430 (94.9) | 60 338 (95.3) | 1.09 (1.05 to 1.13) | 1.07 (1.03 to 1.12) | 0.3 (0.1 to 0.4) |
| Rural | 70 469 (4.9) | 2861 (4.5) | Ref | Ref | – |
| Unknown | 3722 (0.2) | 144 (0.2) | – | – | |
| Comorbidities‡ | |||||
| 0 | 667 123 (46.1) | 20 715 (32.7) | Ref | Ref | – |
| 1 | 441 435 (30.5) | 18 660 (29.5) | 1.38 (1.35 to 1.41) | 1.07 (1.05 to 1.10) | 0.3 (0.2 to 0.4) |
| 2 | 202 348 (14.0) | 12 565 (19.8) | 2.07 (2.02 to 2.11) | 1.20 (1.17 to 1.23) | 0.8 (0.7 to 0.9) |
| 3 | 90 552 (6.3) | 6929 (10.9) | 2.59 (2.51 to 2.66) | 1.34 (1.30 to 1.39) | 1.4 (1.2 to 1.6) |
| 4–8 | 47 163 (3.3) | 4474 (7.1) | 3.27 (3.16 to 3.38) | 1.51 (1.46 to 1.58) | 2.1 (1.9 to 2.4) |
| Diagnostic category, ICD-10§ | |||||
| Factors influencing health status and contact with health Services | 68 761 (4.7) | 484 (0.8) | 0.32 (0.29 to 0.35) | 0.41 (0.37 to 0.44) | −2.6 (−2.8 to −2.5) |
| Certain infectious diseases | 59 478 (4.1) | 1399 (2.2) | 1.07 (1.02 to 1.13) | 0.93 (0.87 to 0.98) | −0.3 (−0.5 to −0.1) |
| Diseases of the eye, adnexa, ear and mastoid process | 84 936 (5.9) | 859 (1.4) | 0.46 (0.42 to 0.49) | 0.34 (0.32 to 0.36) | −3.0 (−3.1 to −2.9) |
| Diseases of the respiratory system | 160 635 (11.1) | 4266 (6.7) | 1.22 (1.17 to 1.26) | 0.94 (0.90 to 0.97) | −0.2 (−0.4 to −0.1) |
| Diseases of the digestive system | 64 925 (4.5) | 8440 (13.3) | 6.70 (6.46 to 6.88) | 4.82 (4.66 to 4.98) | 12.0 (11.7 to 12.5) |
| Diseases of the skin and subcutaneous tissue | 91 297 (6.3) | 1089 (1.7) | 0.54 (0.51 to 0.57) | 0.57 (0.54 to 0.61) | −1.9 (−2.0 to −1.7) |
| Diseases of the musculoskeletal system and connective | 142 323 (9.8) | 1552 (2.5) | 0.49 (0.47 to 0.52) | 0.42 (0.40 to 0.44) | −2.7 (−2.8 to −2.6) |
| Tissue | 1.1 (0.7 to 1.2) | ||||
| Diseases of the genitourinary system | 89 448 (6.2) | 3072 (4.8) | 1.59 (1.52 to 1.66) | 1.25 (1.19 to 1.30) | 4.9 (4.7 to 5.0) |
| Symptoms, signs and abnormal clinical and laboratory findings | 213 601 (14.7) | 20 670 (32.6) | 4.78 (4.66 to 4.91) | 2.49 (2.42 to 2.56) | |
| Injury, poisoning and certain other consequences of external causes | 385 039 (26.6) | 8437 (13.3) | Ref | Ref | – |
| Other† | 147 656 (10.2) | 13 348 (21.1) | 4.85 (4.72 to 4.99) | 4.27 (4.14 to 4.40) | 9.4 (9.1 to 9.7) |
| Neoplasms | 1476 (0.1) | 273 (0.4) | – | – | |
| Disorders of blood involving immune system | 4199 (0.3) | 650 (1.0) | – | – | |
| Endocrine, nutrition and metabolic disorders | 7948 (0.5) | 1162 (1.8) | – | – | |
| Mental and behavioural disorders | 14 152 (1.0) | 1509 (2.4) | – | – | |
| Diseases of nervous system | 17 026 (1.2) | 1034 (1.6) | – | – | |
| Diseases of the circulatory system | 29 784 (2.1) | 7335 (11.6) | – | – | |
| Pregnancy, childbirth and the puerperium | 13 239 (0.9) | 1094 (1.7) | – | – | |
| Certain conditions origination in the perinatal period | 7 (0.0) | 2 (0.0) | – | – | |
| Congenital malformations, deformations and | 289 (0.0) | 9 (0.0) | – | – | |
| Chromosomal abnormalities | |||||
| External coucals of morbidity and mortality | 68 (0.0) | 7 (0.0) | – | – | |
| Intercept | 0.01 (0.01 to 0.01) | ||||
| Concordance statistic¶ | 0.84 (0.84 to 0.85) |
*Adjusted model.
†Combined into ‘CTAS 1 and 2’ and ‘other’ category due to small cell sizes.
‡Total of comorbidities present at urgent care visit, included: hypertension, diabetes, chronic obstructive pulmonary disease, asthma, rheumatoid arthritis, congestive heart failure, bowel disease, cancer.
§Represents primary diagnosis of urgent care visit.
¶Reported as the area under the receiver operating characteristic curve (95% CI).
CTAS, Canadian Triage and Acuity Scale; ICD-10, International Statistical Classification of Diseases 10th Revision.