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Coordination Across Ambulatory Care: A Comparison of Referrals and Health Information Exchange Across Convenient and Traditional Settings

Chang, Ji, PhD; Chokshi, Dave, MD; Ladapo, Joseph, MD, PhD

Journal of Ambulatory Care Management: April/June 2018 - Volume 41 - Issue 2 - p 128–137
doi: 10.1097/JAC.0000000000000227
Original Articles

Urgent care centers have been identified as one means of shifting care from high-cost emergency departments while increasing after-hours access to care. However, the episodic nature of urgent care also has the potential to fragment care. In this study, we examine the adoption of 2 coordination activities—referrals and the electronic exchange of health information—at urgent care centers and other ambulatory providers across the United States. We find that setting is significantly associated with both health information exchange and referrals. Several organization-level variables and environment-level variables are also related to the propensity to coordinate care.

College of Global Public Health (Dr Chang) and School of Medicine (Dr Chokshi), New York University, New York; and UCLA School of Medicine, Los Angeles, California (Dr Ladapo).

Correspondence: Ji Chang, PhD, College of Global Public Health, New York University, 719 Broadway, New York, NY 10003 (

The authors have no conflict of interest or sources of funding to report.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved