Abstract
<title>Abstract</title> <p>Traditional urgent care offers timely, walk-in treatment for acute conditions, but its contribution to healthcare access depends on where centers locate. This study examines whether the 2019 geography of traditional urgent care in the contiguous United States and District of Columbia more closely reflects unmet primary-care need or market conditions favorable to private entry. A proprietary dataset identifies approximately 7,900 centers meeting standardized criteria for extended hours, walk-in access, and on-site imaging. Facility locations are linked to 72,514 census tracts and 3,108 counties, American Community Survey characteristics, emergency departments, limited urgent care facilities, and federal primary-care shortage designations. Descriptive accessibility measures, two-part location models, and spatial specifications distinguish market entry from the number of centers after entry and compare local conditions with those in surrounding areas. Traditional urgent care is present in nearly half of counties but only 9.8\% of census tracts. Entry and conditional counts are most consistently associated with urbanization, private insurance coverage, emergency departments, and limited urgent care facilities. Primary-care shortage status predicts entry only in selected specifications, while shortage intensity does not predict additional centers after entry. Spatial results show regional clustering across counties but local spacing across nearby tracts. Market-driven expansion has created broad national coverage, but it has not systematically directed additional capacity toward areas with the greatest measured shortages.</p>