Retail clinics offer similar quality, cost less, study says

To see if retail clinic visits disrupted preventive care, as some critics have feared, the researchers also tracked insurance claims for three months after the initial visit to each of the four settings to find out if there were differences in patients receiving such unrelated care as immunizations, mammograms, or colonoscopies. They also tracked costs.

Retail clinics provided similar quality care for the three illnesses compared to doctors' offices and urgent care centers and better care compared to emergency departments, based on adherence to national guidelines, the researchers found. Patients who went to retail clinics also received similar levels of preventive care compared to patients who went to other providers.

The costs were lower at retail clinics, averaging $110 at retail clinics compared to $166 at doctors' offices, $156 at urgent care centers, and $570 at emergency departments.

"This is at least preliminary evidence, as we try to improve value in the health care system, that retail clinics may be one way to go," lead author Dr. Ateev Mehrotra, a researcher at Rand and a professor at the University of Pittsburgh, said in an interview.

The study's findings do not dispel concerns about continuity of care, Massachusetts Medical Society president Dr. Mario Motta said.

"From the physician's standpoint, in order to give high-quality care you have to know a series of episodes and know the history over a long period of time," he said. "Fragmented care doesn't improve quality, it diminishes quality. You cannot equate a limited service clinic to a full-fledged physician's office."

In a separate study led by Mehrotra that also appears in today's Annals, the researchers found that one-third of the urban US population lives within a 10-minute drive of retail clinics. In Massachusetts, there are 17 MinuteClinics in CVS pharmacies in Eastern Massachusetts, but none in Boston. Walgreens approached the state Department of Public Health last year with an initial plan for some Take Care Clinics, including one in Boston, but a Walgreens spokesman said yesterday that their launch and the number of clinics was still undetermined, with no openings expected before the end of the year.

The RAND study was funded by the California HealthCare Foundation.