Department of Family Medicine, Mayo Clinic-Rochester, Rochester, MN 55905, USA.
Popul Health Manag. 2009 Dec;12(6):333-5. doi: 10.1089/pop.2009.0007.
Retail medicine clinics have become widely available. However, few studies have been published that compare retail clinic costs of care to standard medical visits for similar patients. The purpose of this study was to compare standard medical costs during a 6-month period after visiting a retail medical clinic to care received in a conventional medical office setting. Medical records of primary care patients (both adults and children) seen in a large group practice in Minnesota in 2008 were analyzed for this study. Two groups of patients were studied: those who used a retail walk-in clinic (N = 141) and a comparison group who used regular office care for same-day, acute visits (N = 137). Patients treated for 5 common conditions (pink eye, sore throat, viral illness, bronchitis, and cough) were selected. The dependent variables were standard costs using federal rates and the rank of standard costs. Multiple linear regression analysis was used to adjust for differences between groups. Median costs did not differ between sites ($126.30 for usual care and $88.10 for retail, P = 0.139); mean cost ranks were 132.5 for usual care and 115.6 for retail (P = 0.088). After adjusting for previous visit history, age, and sex, patients who received care in the retail setting had lower standard costs and lower cost rank than patients who received usual care (b = -52.9 [P = 0.006] and b = -24.5 [P = 0.021], respectively). After selection of cases with common conditions and adjustment for unequal variances, age, sex, and number of office visits in the previous 6 months, our retail clinic appeared to reduce medical costs for patients during the 6-month period after the index visit.
零售医疗诊所已经变得非常普遍。然而，很少有研究比较零售诊所护理的成本与类似患者的标准医疗就诊的成本。本研究的目的是比较在零售医疗诊所就诊后 6 个月内的标准医疗费用与传统医疗办公室就诊的医疗费用。本研究分析了 2008 年明尼苏达州一家大型实践中的初级保健患者（包括成人和儿童）的医疗记录。研究了两组患者：一组是使用零售诊所的患者（N=141），另一组是使用常规办公室就诊的患者（N=137），用于同日的急性就诊。选择了 5 种常见疾病（红眼病、喉咙痛、病毒性疾病、支气管炎和咳嗽）进行治疗。因变量是使用联邦费率和标准费用等级的标准费用。使用多元线性回归分析来调整组间差异。常规护理和零售护理的中位费用无差异（常规护理为 126.30 美元，零售护理为 88.10 美元，P=0.139）；平均费用等级分别为常规护理 132.5 分，零售护理 115.6 分（P=0.088）。在调整了之前就诊史、年龄和性别后，在零售环境中接受护理的患者的标准费用和费用等级均低于在常规护理中接受护理的患者（b=-52.9[P=0.006]和 b=-24.5[P=0.021]）。在选择了常见疾病病例，并调整了不等方差、年龄、性别和之前 6 个月的就诊次数后，我们的零售诊所似乎在就诊后 6 个月内降低了患者的医疗费用。
