Rand Corp. reports use of retail health clinics increased fourfold from 2007 to 2009

Between 2007 and 2009, an increase in the number of retail medical clinics across the country helped spur a four-fold upsurge in their use according to new research from the Rand Corp.

Visits to retail clinics increased to nearly 6 million in 2009 up from 1.48 million just two years earlier, with seniors making increasing use of the services offered such as vaccinations and flu shots. In 2007 seniors accounted for just 8 percent of all visits, but increased to 19 percent in 2009. The study was published online as a Web First article of the journal Health Affairs.

According to Ateev Mehrotra, an associate professor at the University of Pittsburgh School of Medicine and a researcher for Rand Corp., the increased use of these services by seniors can largely be attributed to the convenience of receiving vaccinations at these clinics. “It is the flu shot in particular and there is more awareness and familiarity (of these services) that has caused the increase.”

“The number of vaccinations provided at retail clinics could grow even larger if providers started counseling patients about the need for inoculations when they visit the clinics for other care,” added Lori Uscher-Pines, an associate policy researcher at RAND, in a press release.

While the use of retail clinics is growing rapidly, the report notes that the 5.97 million visits in 2009 still represent a very small fraction of the estimated 117 million emergency room visits and 577 million visits to doctors offices made each year.

In addition to vaccinations, retail clinics also typically provide care for such conditions as sinusitis, bronchitis, ear infections, urinary tract infections and strep throat, as well as preventive care services. These clinics are also typically staffed by a nurse practitioner, as opposed to a doctor, and the amount charged for services is also markedly lower than other alternatives.

“in some prior work where we have compared the cost of care, we found that in comparison to a doctor’s office, retail clinics were 30 to 40 percent cheaper and if you compared to an emergency room on average, they were 80 percent cheaper,” Mehrotra said. “So there are significant savings at retail clinics.”

These savings may be one reason that nearly 33 percent of all patients who visit a retail clinic lack health insurance and an even greater proportion pay cash for their visits.

Further, Mehrortra noted, the proportion of patients seen at retail clinics who don’t have a regular doctor is very high – about 60 percent – suggesting that their increased use can be of benefit to an underserved population.

Finally, while he wouldn’t speculate on what affect major provisions of the Affordable Care Act would have on driving the continued growth of these clinics, he noted that “[i]f demand for primary medical care drives longer wait times to see a doctor as it has following healthcare reform in Massachusetts, then this could drive greater demand for convenient alternatives such as retail clinics."

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