Retail clinics have little effect on visits to nearby EDs: 3 study findings

Although retail clinics are often touted as a means to reduce visits to the emergency department, retail clinics that opened near EDs had a minimal effect on the rates of low-acuity visits to them, according to the results of a study published in Annals of Emergency Medicine.

An accompanying editorial suggests the primary effect of opening retail clinics is to increase healthcare use, not a substitute for visiting the ED.

"Retail clinics may emerge as a way to satisfy the growing demand for healthcare created by people newly insured under the ACA, but contrary to our expectations, they do not appear to be leading to meaningful reductions in low-acuity emergency department visits," said lead study author Grant Martsolf, PhD, RN, of the RAND Corporation in Pittsburgh. "Although the growth in retail clinics has been significant in recent years, the only decrease in low-acuity visits to emergency departments was seen among patients with private insurance, and that decrease was very small."

Here are three things to know about the study's main findings.

1. The number of retail clinics grew from 130 in 2006 to nearly 1,400 in 2012. The rate of clinic penetration, or the proportion of the ED catchment area that overlaps with a 10-minute drive radius of a retail clinic, more than doubled between 2007 and 2012 among states in the study sample. One-third of the urban population in the U.S. lives within a 10-minute drive of a retail clinic.

2. During the same period of time, low-acuity visits among EDs with a significant increase in retail clinic penetration (10 percent per quarter) decreased by 0.03 percent per quarter and only among patients with insurance. This decrease comes out to roughly 17 fewer ED visits among privately insured patients over the course of the year for the average ED if the retail clinic penetration rate increased by 40 percent in that year.

3. The accompanying editorial offers three theories as to why retail clinics increase use of healthcare services. First, they meet unmet demands for care. Second, motivations for seeking care differ in EDs and retail clinics, and finally, groups of people who are more likely to use EDs for low-acuity conditions do so because they have limited access to other types of care, including retail clinics.

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