RAND Health, Pittsburgh, PA, USA.
J Am Board Fam Med. 2010 Jan-Feb;23(1):42-8. doi: 10.3122/jabfm.2010.01.090033.
As a rapidly growing new health care delivery model in the United States, retail clinics have been the subject of much debate and controversy. Located physically within a retail store, retail clinics provide simple acute and preventive services for a fixed price and without an appointment. Some hope that retail clinics can be a new safety-net provider for the poor and those without a primary care physician. To better understand the potential for retail clinics to achieve this goal, we describe the sociodemographic characteristics of the communities in which they operate.
We created an inventory of all retail clinics in the United States and determined the proportion that are in a health professional shortage area (HPSA). We defined each retail clinic's catchment area as all census blocks that were less than a 5-minute driving distance from the clinic. We compared the sociodemographic characteristics of the population within and outside of these retail clinic catchment areas.
Of the 982 clinics in 32 states, 88.4% were in an urban area and 12.5% were in an HPSA (20.9% of the US population lives within an HPSA). Compared with the rest of the urban population, the population living within a retail clinic catchment area has a higher median household income ($52,849 vs $46,080), is better educated (32.6% vs 24.9% with a college degree), and is as likely to be uninsured (17.7% vs 17.0%). In a multivariate model, the census block's median household income had the strongest association with whether the census block was in a retail clinic catchment area (odds ratio, 3.63; 95% CI, 3.26-4.05; median income, > or =$54,779 vs <$30,781, respectively).
We found that relatively few retail clinics are located in HPSAs and that, compared with the rest of the urban population, the population living in close proximity to a retail clinic has a higher income.
作为美国一种快速发展的新医疗服务模式，零售诊所一直是争议的焦点。零售诊所位于零售店内，提供简单的急性和预防服务，价格固定，无需预约。有人希望零售诊所可以成为为贫困人群和没有初级保健医生的人群提供新的医疗保障网。为了更好地了解零售诊所实现这一目标的潜力，我们描述了它们运营所在社区的社会人口统计学特征。
我们创建了美国所有零售诊所的清单，并确定了处于医疗专业短缺地区（HPSA）的诊所比例。我们将每个零售诊所的服务范围定义为距离诊所不到 5 分钟车程的所有普查块。我们比较了这些零售诊所服务范围内和范围外的人口的社会人口统计学特征。
在 32 个州的 982 家诊所中，88.4%位于城市地区，12.5%位于 HPSA（20.9%的美国人口居住在 HPSA 内）。与城市人口的其余部分相比，居住在零售诊所服务范围内的人口的家庭中位数收入更高（$52,849 对$46,080），教育程度更高（32.6%对 24.9%具有大学学历），并且没有保险的可能性相同（17.7%对 17.0%）。在多变量模型中，普查块的家庭中位数收入与该普查块是否在零售诊所服务范围内的关系最强（优势比，3.63；95%置信区间，3.26-4.05；中位数收入，>或= $54,779 对<$30,781）。
我们发现相对较少的零售诊所位于 HPSA，与城市人口的其余部分相比，居住在零售诊所附近的人口收入较高。
