Effect of Retail Clinic Use on Continuity of Care Among Medicare Beneficiaries
| Autor: | Mukaila A. Raji, Nicole Huang, Yong Fang Kuo, N. Ogechi Abara |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry Health care provider 030503 health policy & services technology industry and agriculture Public Health Environmental and Occupational Health Primary care physician Medicare beneficiary Odds ratio 03 medical and health sciences 0302 clinical medicine Ambulatory care Retail clinic Family medicine Medicine Continuity of care 030212 general & internal medicine 0305 other medical science Family Practice business Medicaid health care economics and organizations |
| Zdroj: | The Journal of the American Board of Family Medicine. 32:531-538 |
| ISSN: | 1558-7118 1557-2625 |
| DOI: | 10.3122/jabfm.2019.04.180349 |
| Popis: | Purpose: We examined the relationship between retail clinic use and primary care physician (PCP) continuity among Medicare enrollees in the Houston metropolitan area. Methods: We identified retail clinic providers in the study area using a 2015 health care provider database. Medicare claims data from enrollees who received care from retail clinics in 2015 were compared with propensity score-matched sample of enrollees who received no care from retail clinics. Results: There were 2.32 retail clinic visits per 1000 beneficiaries in a month. Approximately 1.3% of Medicare beneficiaries used retail clinics. Retail clinic users were more likely to be aged 65 to 74 years, female, White, and Medicaid ineligible. In multivariable analyses with adjustments for covariates, significant predictors of retail clinic use included having ≥3 chronic conditions (Odds Ratio [OR], 1.53 vs no condition), living within 1 mile of a retail clinic (OR, 2.44 vs living ≥5 miles), and having no PCP (OR, 1.11 vs having PCP). Compared with propensity-matched controls, among enrollees with an identified PCP, likelihood of seeing their PCP (OR, 0.82; 95% CI, 0.73 to 0.93) and continuity of care was lower (0.75 ± 0.33 vs 0.80 ± 0.31) if they had retail clinic visits. Conclusions: Retail clinic use was lower in the elderly population compared with the previously published rate in the younger populations. The lower rate of continuity of care observed among retail clinic users is concerning, especially for those with chronic medical conditions. |
| Databáze: | OpenAIRE |
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