Dr Lesley Russell, an Australian working in Washington, has been looking at new research conducted in the US on the merits of retail outlets as sites for health clinics. You can just imagine what the AMA might have to say about this.
“A study released in the US this month is sure to provoke a range of reactions from health care professionals in Australia. It found that walk-in medical clinics runs by retailers provide care for routine illnesses that is as good as, and costs less than, similar care offered in doctors’ offices, hospital emergency rooms and urgent care centres.
Retail medical clinics are walk-up medical providers typically located in drug stores and other retail chain stores such as Target and Wal-Mart rather than in medical facilities. Care most often is provided by nurse practitioners rather than by doctors.
The study compared the care provided in different settings for patients with middle ear infections, sore throats and urinary tract infections. Researchers found no difference in the quality offered to patients visiting retail clinics, physician offices and urgent care centers, but retail clinics did slightly better than hospital emergency departments.
The quality of medical care was judged using 14 indicators of quality and whether patients received seven preventive care services during the initial visit or over the subsequent three months.
Quality scores for retail clinics were equal to or higher than those in other care settings. The study found that the costs of treating the acute illnesses at retail clinics were 30 percent to 40 percent lower than in physician offices or urgent care centers and 80 percent lower than in emergency departments. The differences were primarily caused by lower payments for professional services and lower rates of laboratory testing.
A second related study found that more enterprises are beginning to operate retail medical clinics, with an increasing number of hospital chains and physician groups becoming involved.
Retailer Wal-Mart has partnered with local hospitals to co-brand clinics in its stores, and MinuteClinic and the Cleveland Clinic recently announced a partnership to run nine clinics together and to integrate electronic medical records.
These studies were published in the Annals of Internal Medicine, 1 September 2009. Abstracts are available here.
• Dr Lesley Russell is Menzies Foundation Fellow at the Menzies Centre for Health Policy at the University of Sydney and the Australian National University.