A recent RAND study found that many emergency visits could be handled through retail clinics or urgent care centers. The article claims that this could reduce US health care spending by over $4 billion a year.
This redirection of most acute issues to retail clinics and urgent care centers seems like an appropriate and great recommendation considering the lack of PCPs, timely access to care issues, and high inappropriate use of ER for non-emergency care. However, I wonder about the quality of care patients will receive at retail clinics. Does anyone know if there are current guidelines for these clinics and if not, will or should there be guidelines? Also, I think it is important to discuss the implications for lack of coordination of care that might arise if consumers become reliant on retail clinics and urgent care centers.
Business Week Article: http://www.businessweek.com/lifestyle/content/healthday/642813.html
Original Article: http://content.healthaffairs.org/cgi/reprint/29/9/1630
1 comment:
Interesting concept. I have not heard of any patients actually going to retail clinics for care. Emergency rooms are definitely over-crowded & people with these minor conditions can wait many long hours waiting to be seen, so this is a possible alternative. However, I became skeptical of the concept when I began thinking about how bad people are at triaging themselves. I have seen many patients with serious conditions, like an undiagnosed cancer or major infection, show up to to the emergency room with a seemingly benign and/or unrelated complaint. Although patients may focus on trying to get treatment for their benign problem, their more serious diagnosis is usually revealed through a history and physical examination by ER doctors. If patients triage themselves to these retail clinics, it seems likely that serious diagnoses will be missed. In addition, these clinics target patient populations that lack access to primary care providers, so these patients are unlikely to recieve proper follow-up care for any of their conditions. I am also concerned that patients will use these clinics as a substitute for proper primary care for treatment of conditions like diabetes or hypertension. The lack of continuity of care and lack of training to treat these chronic conditions may also lead to suboptimal care.
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