November 14, 2012
Do Retail Clinics Disrupt Patients’ Primary Care?

Pittsburgh—Patients who visit retail medical clinics in pharmacies and other locations are less likely to return to their primary care physicians the next time they get sick, according to a new RAND Corporation report.

Yet, researchers examining the impact of retail medical clinics on the receipt of primary medical care found no evidence that use of retail medical clinics disrupted two key measures of primary care quality—preventive medical care or management of diabetes.

The report was published online recently by the Journal of General Internal Medicine.

“There is concern whether retail clinics may disrupt the relationship between patients and their personal physicians, which may make it difficult to maintain the quality and continuity of medical care,” said senior author Ateev Mehrotra, MD, MPH, an associate professor at the University of Pittsburgh School of Medicine and a researcher at RAND. “We found use of retail clinics did have a negative impact on some aspects of primary care.”

Usage of the nation’s more than 1,300 retail clinics is on an upswing. Previous RAND research noted that visits to the clinics increased tenfold from 2007 to 2009 among those with commercial health insurance.

The study focusing on the link between retail clinics and use of primary care providers examined the records of more than 120,000 commercial health insurance beneficiaries who used a retail medical clinic for an acute medical condition during 2008. Those included 11 common ailments such as respiratory or urinary tract infections.

The patients’ medical care a year before the visit and a year afterward were reviewed and compared to patients who visited a primary care physician for an acute health problem during the same period.

Researchers found that those who had visited a retail medical clinic were less likely to go to a primary care physician the next time they needed similar care over the next 12 months. They also demonstrated less continuity of care.

Study authors said it was unclear whether that had much impact on overall quality of primary care, however.

“The interpretation of our findings depends on one's view about the relative importance of different aspects of primary care,” said study author Rachel O. Reid of the University of Pittsburgh School of Medicine. “Retail clinics are still in their infancy and over time we may or may not observe a more negative impact of retail clinics on preventive care or continuity of medical care.”

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