Sept. 10, 2008 -- If you need non-emergency medical care, where would you go? A physician's office? The emergency room? A retail medical clinic?
That's what researchers from RAND wanted to find out. They are releasing results of a new study that looks at how people use retail clinics, which are sometimes found in drugstores, grocery stores, and large retailers like Wal-Mart.
The research team, led by Ateev Mehrotra, MD, MPH, with RAND and the University of Pittsburgh School of Medicine, compiled data from nearly a million and a half retail clinic visits.
The researchers note that the study was not funded by retail clinics, nor was anyone paid to provide the data.
They looked for information like gender, age, how the visit was paid for, whether the patient had a primary care physician, whether the patient moved to an emergency room, and what prompted them to go to a retail clinic.
They also looked at separate national data from 35,814 visits to primary care physicians and 147,784 visits to emergency rooms.
Who Uses Retail Clinics?
Among the findings:
- Men and women seem to equally go to retail clinics.
- 18- to 44-year-olds made twice as many visits to retails clinics (43% compared with 23%) as visits to their primary care physician.
- The youngest and oldest patients are least likely to visit retail clinics and more likely to go to a doctor's office or emergency room.
- In 39% of visits, people who went to a retail clinic reported having a primary care physician. (That's compared to 80% of people nationwide who say they have a personal doctor.)
- 2.3% of visits to a retail clinic were triaged to an emergency room or a doctor's office.
"These clinics appear to attract patients who are not routine users of the current health care system," Mehrotra says in a news release. "For these patients, the convenience offered by retail clinics may be more important than the continuity provided by a personal physician."
Retail Clinic Payments
More retail clinic visits were paid for out of pocket when compared with payment for primary care physicians. But the study findings reflect that may be changing.
The first retail clinic opened in the U.S. in 2000. The researchers found that 100% of visits were paid out of pocket in 2000. But in 2007, 16% of retail clinic visits were paid for out of pocket.
Why Do People Go to Retail Clinics?
The study found that 90% of retail clinic trips are for 10 common medical conditions that include:
- Upper respiratory infections
- Pharyngitis (throat infection)
- Middle ear infection
- Swimmer's ear
- Urinary tract infections
- Screening lab tests or to have blood pressure checked
Of those folks 65 years old or older who visit retail clinics, 74% of those visits were to get immunizations.
In background information presented with the findings, researchers write that more retail clinics are springing up all over the country.
Researchers cite studies that suggest that the number of clinics will explode from the current 450 to 6,000 in the next five years.
There has been some controversy since the clinics were launched, with concerns about quality of care, less chances for primary care doctors to take care of chronic medical conditions and preventive care, disruption of the relationship that a patient has with his/her primary care doctor, and coordination of patient care.
"Future studies should investigate quality, the likelihood that patients are getting needed preventive and follow-up care," Mehrotra says.
He adds, "There is a lot of curiosity and questions about retail health clinics because they are a new way of providing care in a system of health that has seen little change over the past 50 years in how care is delivered."