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	Living on the Edge: Health Care Expenses Strain Family Budgets Research Brief

American Families' Use of Retail-Based Health Clinics Remains Modest

Younger Families and Those with Access Problems More Likely to Use In-Store Clinics

News Release
Dec. 15, 2008

FURTHER INFORMATION, CONTACT:
Alwyn Cassil (202) 264-3484 or acassil@hschange.org

WASHINGTON, DC—Despite rapid growth of retail clinics, only a tiny fraction of American families in 2007 had ever used the in-store clinics, typically located in pharmacies, supermarkets and big-box retailers, according to a national study released today by the Commonwealth Fund and conducted by the Center for Studying Health System Change (HSC).

The number of retail clinics has grown rapidly in recent years, from about 60 retail clinics in 18 states at the beginning of 2006 to more than 900 in 30 states by the end of 2007.

As of 2007, 2.3 percent of American families, or nearly 3.4 million families, had ever used a retail clinic, according to findings from HSC’s 2007 Health Tracking Household Survey, a nationally representative survey with information on about 18,000 people in 9,400 families. The survey had a 43 percent response rate.

Of the families reporting they had ever used a retail clinic, about half reported visiting a retail clinic in the prior 12 months before the survey interview, while the other half reported they had visited a retail clinic during an earlier period.

The study found that families that reported not getting or delaying needed medical care at some point in the previous 12 months were almost 2.5 times as likely to have used a retail clinic as families without such access problems (1.9% vs. 0.8%). Also, younger families-those with a family respondent aged 18-34-were more than twice as likely as older families-those with a family respondent aged 50-64-to have used a retail clinic.

"While overall use of retail clinics remains modest, families with unmet medical needs tend to use the clinics more than the rest of the population," said Ha T. Tu, M.P.A., an HSC senior researcher and coauthor of the study with Genna R. Cohen, an HSC health research assistant.

"These findings suggest that retail health clinics have the potential to play a role in improving health care delivery, especially primary care," said Commonwealth Fund Vice President Anne-Marie Audet, M.D.

The study’s findings are detailed in a new Commonwealth Fund Issue Brief—Checking Up on Retail-Based Health Clinics: Is the Boom Ending?—available online at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=730365

Other key findings include:

• Among all families that used retail clinics in the past year, uninsured families-defined as families with any member lacking health insurance-accounted for 27 percent of clinic users, the study found.
• Nearly half (48%) of all consumers using retail clinics reported they had done so for diagnosis and treatment of a new illness or symptom. Almost as many (47%) said that their visit had included a prescription renewal. Other less common reasons cited by consumers were vaccinations, care for an ongoing chronic condition and physical examinations.
• Almost two in three people said that the clinic’s convenient hours were a major factor in choosing it over another source of care. The convenience of the clinic’s location and the ability to receive care without an appointment also were commonly cited as major reasons for choosing clinics. Seven of eight clinic users cited at least one of these three convenience factors as a major reason for choosing clinics, and one in three cited all three convenience factors as major reasons.
• Nearly half of all clinic users cited the low cost of a clinic visit relative to other care settings, and one in three cited not having a usual source of medical care, as major reasons for choosing clinics over other care settings.
• The likelihood of citing cost concerns and the lack of a usual source of care as major factors were much higher among uninsured and minority clinic users, compared with their insured and white counterparts, respectively. For example, uninsured clinic users were more than 3.5 times more likely than insured clinic users to cite not having a usual source of care as a major reason for choosing clinics over other care settings.

The Commonwealth Fund is a private foundation working to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy.

The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.