Retail Medical Clinics Just as Effective and Cost Less

A recent RAND Corporation study published in the Annals of Internal Medicine concludes that retail medical clinics provide equivalent quality of care for 3 common illnesses for less money:

Comparing Costs and Quality of Care at Retail Clinics With That of Other Medical Settings for 3 Common Illnesses


Mehrotra A, Hangsheng L, Adams JL, Wang MC, Lave JR, Thygeson NM, Solberg LI, McGlynn EA. Annals of Internal Medicine, 2009; 151:321-328.

Background

Retail clinics are an increasingly popular source for medical care. Concerns have been raised about the effect of these clinics on the cost, quality, and delivery of preventive care.

Objective

To compare the care received at retail clinics for 3 acute conditions with that received at other care settings.

Design

Claims data from 2005 and 2006 from the health plan were aggregated into care episodes (units that included initial and follow-up visits, pharmaceuticals, and ancillary tests). after 2100 episodes (700 each) were identified in which otitis media, pharyngitis, and urinary tracts infection (UTI) were treated first in retail clinics, these episodes were matched with other episode in which these illnesses were treated first in physician offices, urgent care centers, or emergency departments.

Setting

Enrollees of a large Minnesota health plan.

Patients

Enrollees who received care for otitis media, pharyngitis, or UTI.

Measurements

Cost per episode, performance on 14 quality indicators, and receipt of 7 preventive care services at the initial appointment or subsequent 3 months.

Results

Overall costs of care for episodes initiated at retail clinics were substantially lower than those of matched episodes initiated at physician offices, urgent care centers, and emergency departments ($110 vs. $166, $156, and $570, respectively; P < 0.001 for each comparison). Prescription costs were similar in retail clinics, physician offices, and urgent care centers ($21, $21, and $22), as were aggregate quality scores (63.6%, 61.0%, and 62.6%) and patient's receipt of preventive care (14.5%, 14.2%, and 13.7%) (P > 0.05 vs retail clinics). In emergency departments, average prescription costs were higher and aggregate quality scores were significantly lower than in other settings.

Limitations

A limited number of quality measures and preventive care services were studied. Despite matching, patients at different care sites might differ in their severity of illness.

Conclusion

Retail clinics provide less costly treatment than physician offices or urgent care center for 3 common illnesses, with no apparent adverse effect on quality of care or delivery of preventive care.

Primary Funding Source

California HealthCare Foundation