Ashwood J Scott, Gaynor Martin, Setodji Claude M, Reid Rachel O, Weber Ellerie, Mehrotra Ateev
J. Scott Ashwood is an associate policy researcher at RAND in Santa Monica, California.
Martin Gaynor is the E. J. Barone Professor of Economics and Health Policy and chair of the Governing Board of the Health Care Cost Institute, both at Carnegie Mellon University, in Pittsburgh, Pennsylvania.
Health Aff (Millwood). 2016 Mar;35(3):449-55. doi: 10.1377/hlthaff.2015.0995.
Retail clinics have been viewed by policy makers and insurers as a mechanism to decrease health care spending, by substituting less expensive clinic visits for more expensive emergency department or physician office visits. However, retail clinics may actually increase spending if they drive new health care utilization. To assess whether retail clinic visits represent new utilization or a substitute for more expensive care, we used insurance claims data from Aetna for the period 2010-12 to track utilization and spending for eleven low-acuity conditions. We found that 58 percent of retail clinic visits for low-acuity conditions represented new utilization and that retail clinic use was associated with a modest increase in spending, of $14 per person per year. These findings do not support the idea that retail clinics decrease health care spending.
政策制定者和保险公司认为，零售诊所是一种降低医疗保健支出的机制，它通过用成本较低的诊所就诊替代成本较高的急诊科或医生办公室就诊来实现。然而，如果零售诊所促使产生新的医疗保健使用需求，那么实际上可能会增加支出。为了评估零售诊所就诊是代表新的医疗服务使用情况还是对更昂贵医疗服务的替代，我们利用了安泰保险公司2010年至2012年期间的保险理赔数据，来跟踪11种低 acuity 病症的医疗服务使用情况和支出。我们发现，针对低 acuity 病症的零售诊所就诊中，58%代表新的医疗服务使用情况，而且使用零售诊所与支出适度增加有关，每人每年增加14美元。这些发现并不支持零售诊所会降低医疗保健支出这一观点。
