jueves, 24 de noviembre de 2016

AHRQ Study Examines Impact of Retail Clinics on Emergency Department Visits

Retail clinics, or medical care outlets located in drug or grocery stores, generally do not reduce visits to nearby emergency departments (ED) for low-acuity conditions such as hay fever, bronchitis, flu and viral infections, according to a new AHRQ study. However, a slight decrease in ED visits for these ailments was shown for patients with private insurance, which the authors said may be attributed to retail clinics being located in higher income, suburban areas. The study compared treatment visits to retail clinics and EDs within a 10-minute driving distance. The analysis was based on ED visits between 2007 and 2012, when the number of retail clinics nationwide grew from about 130 to 1,400. Authors conducted the analysis with data from AHRQ’s Healthcare Cost and Utilization Project, the nation’s most comprehensive source of hospital data, including information on inpatient care, ambulatory care and ED visits. The new study, “Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits,” is the first to directly examine whether retail clinics were associated with reduced ED visits for the ambulatory conditions. Access the abstract of the study, published Nov. 14 in Annals of Emergency Medicine.

2016 Nov 4. pii: S0196-0644(16)30998-2. doi: 10.1016/j.annemergmed.2016.08.462. [Epub ahead of print]

Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits.

Martsolf G1, Fingar KR2, Coffey R2, Kandrack R3, Charland T4, Eibner C5, Elixhauser A6, Steiner C6, Mehrotra A7.

Author information

Abstract

STUDY OBJECTIVE:

We assess whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions.

METHODS:

We used data from the Healthcare Cost and Utilization Project State Emergency Department Databases for 2,053 EDs in 23 states from 2007 to 2012. We used Poisson regression models to examine the association between retail clinic penetration and the rate of ED visits for 11 low-acuity conditions. Retail clinic "penetration" was measured as the percentage of the ED catchment area that overlapped with the 10-minute drive radius of a retail clinic. Rate ratios were calculated for a 10-percentage-point increase in retail clinic penetration per quarter. During the course of a year, this represents the effect of an increase in retail clinic penetration rate from 0% to 40%, which was approximately the average penetration rate observed in 2012.

RESULTS:

Among all patients, retail clinic penetration was not associated with a reduced rate of low-acuity ED visits (rate ratio=0.999; 95% confidence interval=0.997 to 1.000). Among patients with private insurance, there was a slight decrease in low-acuity ED visits(rate ratio=0.997; 95% confidence interval=0.994 to 0.999). For the average ED in a given quarter, this would equal a 0.3% reduction (95% confidence interval 0.1% to 0.6%) in low-acuity ED visits among the privately insured if retail clinic penetration rate increased by 10 percentage points per quarter.

CONCLUSION:

With increased patient demand resulting from the expansion of health insurance coverage, retail clinics may emerge as an important care location, but to date, they have not been associated with a meaningful reduction in low-acuity ED visits.