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Retail Clinics Providing Similar Quality of Care as EDs, Physicians’ Offices

Janice Simmons, for HealthLeaders Media, September 1, 2009

Retail medical clinics are becoming a common site in many cities and towns. The clinics, popular for their lower prices, can provide quality care comparable to that offered in physicians' offices, urgent care centers, or hospital emergency departments, according to two separate studies from RAND appearing in this month's Annals of Internal Medicine.

More than 1,000 retail clinics currently operate in the United States in places such as pharmacies, discount stores, and grocery stores. In addition to lower costs, these clinics require no appointments, are open on weekends and evenings, and report shorter waiting times.

However, since the first retail clinic opened in 2000, several physician organizations, including the American Medical Association and American Academy of Pediatrics, have raised concerns about the quality of care that retail clinics deliver—arguing that visiting a retail clinic could lead to unforeseen complications that result in higher healthcare costs.

To evaluate the validity of those concerns, the researchers analyzed claims data from a large Minnesota health plan that has been providing coverage for its enrollees at retail clinics for more than 5 years. The researchers compared the cost, quality of care, and the delivery of preventive services for 2,100 patients who received care for three conditions commonly treated in retail clinics—otitis media, pharyngitis, and urinary tract infection [UTI]. These episodes were matched with other episodes in which these illnesses were treated first in physician offices, urgent care centers, or emergency departments.

The researcher found that the quality of care in retail clinics was similar to that provided in physician offices and urgent care centers and slightly superior to that of emergency departments.

Nurse practitioners, rather than physicians, generally provide the care in retail clinics. The findings were consistent with previous research that found no difference between the quality of care delivered by nurse practitioners and physicians, according to Ateev Mehrotra, MD, a professor at the University of Pittsburgh School of Medicine and one of the RAND researchers.

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