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More Time Needed to See Full Benefit of Retail Clinics, Studies Find

By Emily Ethridge, CQ Staff

DECEMBER 19, 2008 -- Retail clinics are convenient and keep costs low for many patients, but the vast majority of Americans have never visited one, several reports have found. Although patients report high satisfaction with the clinics, it remains to be seen whether the retail clinics' clientele will expand.

The clinics are found in pharmacies and big-box retailers such as CVS, Walgreens, Target and Walmart. Although the number of clinics is growing rapidly, only a small percentage of American families have ever visited them. The number of retail clinics grew to more than 900 in 30 states by the end of 2007, up from about 60 in early 2006, said a study by the Center for Studying Health System Change (HSC). Yet only 2.3 percent of American families, or about 3.4 million families, had ever used a retail clinic as of 2007.

Minnesota stands out with high rates of clinic use—6.4 percent of the state population have visited a clinic—and Florida has more retail clinics in operation than any other state. The clinics have a more long-standing presence in Minnesota and Florida than in other states.

The clinics provide a valuable source of care for many Americans, especially those without a primary care physician, the HSC survey found. For example, families that reported not receiving or delaying needed medical care within the last year were almost 2.5 times as likely to have used a retail clinic, compared with families who did not report having access problems.

"While overall use of retail clinic remains modest, families with unmet medical needs tend to use the clinics more than the rest of the population," said HSC Senior Researcher Ha T. Tu.

Cost concerns and lacking a primary care physician were major factors for uninsured and minority clinic users in choosing to go to a clinic, the HSC report found. In addition, families where at least one member lacked health insurance accounted for 27 percent of clinic users.

Another report, published in Health Affairs, found that retail clinics serve a patient population that is underserved by primary care options. Three out of five retail clinic patients reported they did not have a primary care physician, and one-third said they did not have insurance, said the report, "Retail Clinics, Primary Care Physicians, And Emergency Departments: A Comparison of Patients' Visits."

"It is possible that retail clinics could serve as a safety-net provider for some patients who now seek care in emergency departments," the Health Affairs report said. Overall, it found that retail clinic patients are more likely to be young adults who pay out of pocket for care and are less likely to have a primary care physician.

In addition, almost all retail clinic visits—more than 90 percent—are for simple conditions, such as upper respiratory infections, and preventive care such as immunizations, the report found.

Consumers choose retail clinics for other reasons as well, such as convenience and low cost, the HSC study found. Nearly two out of three people said they chose the clinic because of its convenient hours, and nearly half said the clinics' low cost contributed to their choice.

"The retail clinics have the potential to improve health care delivery, especially primary care," said Commonwealth Fund Vice President Anne-Marie Audet. The Commonwealth Fund released the HSC report.

Consumers also are satisfied with the care they receive at retail clinics. Another article in Health Affairs, "A Checkup for Retail Medicine," said that independent surveys show about 90 percent satisfaction with retail clinics in the areas of quality care, convenience and cost.

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