August 29, 2012

Visits to Pharmacy Clinics Rise: Will Trend Continue?

Pittsburgh—Visits to retail medical clinics represent a growing segment of the pharmacy business, quadrupling between 2007 and 2009, according to a new Rand Corporation study. The lead author suggests that number could grow with enactment of the federal Affordable Care Act (ACA).

The influenza vaccine, as well as other types of preventive care, was the big driver in the increase, with 47.5% of visitors receiving preventive care at a retail clinic in 2007-2009 compared with 21.8% in 2000-2006, according to the study, published recently in the journal Health Affairs. About 44% of visits to retail medical clinics occurred after hours or on the weekend.

Interestingly, the proportion of Medicare-aged patients older than 65 showed the greatest increase, from 8% to 19%.

“Retail medical clinics continue to grow rapidly and attract new segments of users,” said lead author Ateev Mehrotra, MD, MPH, an associate professor at the University of Pittsburgh School of Medicine and a researcher at RAND, a nonprofit research organization. “They remain just a small part of outpatient medical care, but appear to have tapped into patients' needs.”

Mehrotra suggested, however, that ACA enactment could bolster the trend toward retail clinics.

“If demand for primary medical care drives longer wait times to see a doctor as it has following health care reform in Massachusetts, then this could drive greater demand for convenient alternatives such as retail clinics,” he said.

For the study, researchers examined the latest trends in the use of retail medical clinics by analyzing information from 2007 through 2009 obtained from the three largest retail-clinic operators: MinuteClinic in CVS pharmacies, TakeCare in Walgreens pharmacies, and LittleClinic in Kroger pharmacy locations. The authors point out that those three account for 81% of the clinics operated nationally.

The study said that the 5.97 million visits to retail clinics in 2009 were up from 1.48 million in 2007.

(Retail clinics still serve only a small percentage of the outpatient medical care market, however. According to the study, emergency departments racked up 117 million visits and physician offices had 577 million visits during the same time period.)

A significant increase was noted in visits to retail medical clinics for vaccinations, especially for seasonal influenza. Another recent study published by RAND said that vaccination visits to the three major retail-clinic chains quadrupled to more than 1.9 million in 2009.

"The number of vaccinations provided at retail clinics could grow even larger if providers started counseling patients about the need for inoculations when they visit the clinics for other care," said Lori Uscher-Pines, an associate policy researcher at RAND.

Even with the increase in care, retail clinics are seeing a smaller percentage of patients with acute medical problems, dropping from 78% at the beginning of the study to 51% at the end. Authors note that the statistics do not include visits for chronic care; retail medical clinic operators only began to heavily promote chronic disease services, e.g., diabetes education and monitoring, in 2010.

More than 60% of patients who visited the clinics said they did not have a primary care physician.

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