Retail clinics are augmenting care to the insured and affluent rather than providing a primary source of care to low-income uninsured, concluded a study released last week.
Contrary to some reports, retail clinics are located in more advantaged neighborhoods, with higher rates of the insured, according to the study, published in the Archives of Internal Medicine and funded by the Robert Wood Johnson Foundation.
Researchers at the University of Pennsylvania mapped locations of 930 retail clinics nationwide and compared them to the 2000 U.S. Census and 2008 Health Resources and Services Administration data on health insurance rates, household income, race and ethnicity and other area demographics.
The five states with the most retail clinics as of July 2008 were California, Florida, Georgia, Illinois and Texas. Eighteen states had no retail clinics, according to the report.
Counties with retail clinics had uninsured rates of 1 percentage point lower than those without retail clinics (12.1% vs. 13.3%), and areas with the clinics had a lower percentage of Hispanic and black residents, fewer rental properties and lower poverty rates. Areas with concentrations of retail clinics had residents with higher median income and higher rates of home ownership, according to the study.
“If retail clinics are determined to be a valuable and effective source of care, rethinking the distribution of these clinics may be an important avenue for improving their potential social benefit,” wrote the study authors, Craig Evan Pollack and Katrina Armstrong.
Retail clinics are typically located in pharmacy chain and big-box retail stores, and operated by specialty clinic companies or hospitals. About 85% of retail clinics accept insurance, and most are staffed with nurse practitioners attending to primary- and urgent-care issues.
Still, previous studies have indicated that one-fourth of people who use retail clinics are uninsured and have no regular source of care. The authors speculate that this could be explained by the clustering of retail clinics in metro areas with high population densities. They also suggest that the uninsured may be willing to travel longer distances to areas where there is a retail clinic for care.
Tine Hansen-Turton, executive director of the Convenient Care Association, said that retail clinics are filling a valuable role but aren’t the end-all solution to the healthcare crisis. “Convenient-care clinics are niche providers, providing a relatively limited set of services in a manner that is cost-effective, transparent and convenient, while maintaining a strong commitment to clinical quality,” she said.
A study released last year indicated that retail clinic growth was slowing (Dec. 22/29, 2008, p. 12). There are about 14,000 retail clinics nationwide, Hansen-Turton said.
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