Outpatient pharmacy industry increases scope of care to meet patients' needs

Healthcare delivery in the United States has evolved as more patients visit their neighborhood retail clinics for acute and preventive care.

In a recent Health Affairs report published online (http://content.healthaffairs.org/content/early/2012/08/14/hlthaff.2011.1128.full%20), it was reported that outpatient visits have steadily increased from 1.48 million in 2007 to 5.97 million in 2009. To accommodate this growth in U.S. healthcare demand, the retail clinic industry has rapidly expanded from 300 ambulatory clinics in 2007 to approximately 1,200 facilities in 2009. These clinics are located in pharmacies, grocery stores, and other retail settings. "The rapid growth of retail clinics makes it clear that they are meeting a patient need. Convenience and after-hours accessibility are possible drivers of this growth," the authors wrote.

The scope of care also has changed, with most of the outpatient visits that took place during 2000 to 2006 attributed to common, acute ailments (78.2%), such as upper respiratory infections and urinary tract infections, and simple preventive care (21.8%). In 2007 to 2009, outpatients visits to obtain preventive care, specifically the influenza vaccine, grew to 47.5% of total visits, and a slight uptick was seen in visits for management of chronic diseases (1.1%), including asthma, hypertension, and diabetes. "Visits for vaccinations increased greatly [during 2007-2009]; visits for other types of preventive care also increased, although their overall share remained relatively small," the authors reported.

More elderly patients (14.7% of total visits) took advantage of retail clinics during 2007 to 2009 compared with the previous 6-year period (7.5% of total visits). The increase in patients aged 65 and older was associated with preventive care visits for the purpose of obtaining vaccinations.

Besides convenient hours and accessibility, retail clinics also offer patients a cost-effective choice for their healthcare needs, especially for those patients who do not have a primary care physician.

"Retail clinics offer a low-cost alternative source of care. Some of the growth in Americans' use of clinics probably reflects the increase in the number of people who are more sensitive to cost, such as the uninsured and people with high-deductible health plans," the authors said.

The authors obtained deidentified clinic data from the three largest operators of retail clinics: MinuteClinic, TakeCare Clinic, and LittleClinic, which make up 81% of the U.S. retail clinic industry.