The number of retail clinics grew from 130 in 2006 to nearly 1,400 in 2012. The rate of retail clinic penetration – in other words, the proportion of the emergency department catchment area that overlaps with a 10-minute drive radius of a retail clinic – more than doubled (8.1 to 16.4) between 2007 and 2012 among states in the study sample. One-third of the urban population in the United States lives within a 10-minute drive of a retail clinic.
During the same period, low-acuity visits among emergency departments with significant increase in retail clinic penetration (10 percent per quarter) decreased by 0.03 percent per quarter and only among patients with private insurance. This is equivalent to approximately 17 fewer emergency department visits among privately insured patients over the course of the year for the average emergency department if the retail clinic penetration rate increased by 40 percent in that year.
The accompanying editorial offers three theories as to why retail clinics (described as "convenience settings") increase health care use: 1. They meet unmet demands for care; 2. Motivations for seeking care differ in emergency departments and convenience settings; and 3. Groups of people who are more likely to use emergency departments for low-acuity conditions do so because they have little access to other types of care, including convenience settings.
"Given that convenience settings don't prevent ER visits, what can be done in an era where looming government reforms may soon restrict the very payments that support them?" said Jesse Pines, MD, FACEP, of the George Washington University School of Medicine and Health Sciences in Washington D.C., the editorial's author. "The answer is not to build more convenience settings, but to improve the value of existing settings by increasing the connectivity among providers and with longitudinal care."
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit www.acep.org.
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SOURCE American College of Emergency Physicians (ACEP)