Abstract
INTRODUCTION: Urgent care centers (UC) play an important role in addressing non-emergent health concerns, offering a convenient alternative to emergency departments (ED). However, accessibility to UCs can vary based on transportation availability and socioeconomic factors. In this study we evaluated the geospatial accessibility of UCs and EDs in Milwaukee County, Wisconsin, and sought to characterize the relationship between transit options, socioeconomic vulnerability, and access to care. METHODS: We included 13 EDs and 13 UCs in the study. Public and private transit times between census tracts in Milwaukee County and the nearest UC or ED were calculated using an application programming interface that recorded data from Google Maps. We employed socioeconomic vulnerability index (SEVI) scores to define community vulnerability. Statistical analyses, including Mann-Whitney U tests and Pearson correlation coefficients, were used to determine differences in commute times and their relationship with socioeconomic status. RESULTS: Private transit times were shorter than public transit times when commuting to the nearest ED (7 minutes vs 22 minutes, P <.001) and the nearest UC (9 minutes vs 31 minutes, P < .001). The EDs were generally more accessible than UCs, with shorter transit (22 vs 31 minutes, P < .001) and walk times (11 vs 14 minutes, P <.001). Socioeconomically disadvantaged communities with higher SEVI scores had longer private transit times to UCs (r = 0.17, P = .003) while having shorter public transit times to EDs (r = -.21, P < .001). CONCLUSION: Access to urgent care centers and EDs in Milwaukee County is influenced by socioeconomic factors and transportation modes. While EDs are more accessible to socioeconomically vulnerable communities, UCs are less accessible, which may contribute to higher ED utilization for non-emergent needs. These findings highlight the need to address transportation limitations as a social determinant of health that can impact how disadvantaged populations seek care and the implications for non-emergent ED use and ED crowding.