Study: Few retail clinics in poor neighborhoods

Walk-in retail clinics in grocery and drugstore chains can help the uninsured find health care, proponents say. But a new study suggests most retail clinics aren't in the poorest neighborhoods.

Like most businesses, they go where the money is - to more affluent neighborhoods, which already happen to be well-served by other medical resources.

"Many people have promoted retail clinics as a cure for access to care for the underserved," said Dr. Ateev Mehrotra of the University of Pittsburgh, who studies retail clinics but wasn't involved in the new research. "These findings show that's unlikely to happen."

The study's results suggest financial incentives may be needed to lure the clinics to low-income neighborhoods, said study author Dr. Craig Pollack of the University of Pennsylvania.

Open late and on weekends, the clinics use nurse practitioners to give shots and treat minor ailments such as sore throats and rashes. Visits typically cost $40 to $75, and prices are posted so consumers know what they're paying. People pay cash or use insurance.

Industry leaders CVS Caremark Corp. and Walgreens Co., along with other companies, now run more than 1,200 retail clinics in the United States. Florida has the most with 147 clinics, followed by Texas, California, Illinois, Tennessee and Georgia.

The researchers mapped 930 retail clinics operating last year, then used U.S. Census data to describe the income and racial makeup of the neighborhoods. In counties with at least one retail clinic, the researchers compared census tracts with and without retail clinics.

Only 123 clinics were located in areas defined by the federal government as medically underserved. Tracts with clinics had lower percentages of black and Hispanic residents, lower rates of poverty, higher rates of home ownership and higher median incomes.

The results are published in Monday's Archives of Internal Medicine.

Industry leaders said retail clinics were designed to offer convenient care, not as the health care system's safety net. But they play a role, industry officials acknowledge. The clinics' own research shows 30 to 40 percent of patients say they don't have a primary care provider, said Tine Hansen-Turton of the Convenient Care Association, a trade group representing most of the clinics.

Clinics do link patients with safety-net providers who can treat serious conditions. And they're ready to ramp up to help with a swine flu emergency or with the prospect of millions of newly insured Americans if Congress passes a health care overhaul plan, Hansen-Turton said.

Peter Miller, CEO of Walgreens' Take Care Health Systems, said the company is likely to expand into more drugstores already in medically underserved areas.

The poor and uninsured do make their way to retail clinics, said Margaret Laws, director of the California Healthcare Foundation's Innovations for the Underserved program.

"People go out of their neighborhoods to work and shop," she said. "I don't think we should make the assumption that they won't go out of neighborhoods to seek health care if it offers customer service, better hours and transparent prices."

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On the Net:

Archives: http://www.archinternmed.com

Convenient Care Association: http://www.ccaclinics.org/