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The Geographic Distribution, Ownership, Prices, and Scope of Practice at Retail Clinics

Rena Rudavsky, BS; Craig Evan Pollack, MD, MHS; and Ateev Mehrotra, MD, MPH
[+] Article, Author, and Disclosure Information

From RAND Health, Pittsburgh, Pennsylvania, and Washington, DC; University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania; and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Acknowledgment: The authors thank Mary Kate Scott and Caroline Ridgeway for reviewing the list of retail clinic operators and Preethi Sama and Martha Timmer for their time collecting data and programming.

Grant Support: By the California Healthcare Foundation; a career development award (KL2 RR024154-03) from the National Center for Research Resources, a component of the National Institutes of Health (Dr. Mehrotra); and the Department of Veterans Affairs and the Robert Wood Johnson Foundation Clinical Scholars Program (Dr. Pollack).

Potential Financial Conflicts of Interest: None disclosed.

Reproducible Research Statement:Study protocol, statistical code, and data set: Available from Dr. Mehrotra (e-mail, mehrotra@rand.org).

Requests for Single Reprints: Ateev Mehrotra, MD, RAND Health, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213; e-mail, mehrotra@rand.org.

Current Author Addresses: Ms. Rudavsky and Dr. Pollack: RAND Health, 1200 South Hayes Street, Arlington, VA 22202-5050.

Dr. Mehrotra: RAND Health, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665.

Author Contributions: Conception and design: R. Rudavsky, C.E. Pollack, A. Mehrotra.

Analysis and interpretation of the data: R. Rudavsky, A. Mehrotra.

Drafting of the article: R. Rudavsky, C.E. Pollack, A. Mehrotra.

Critical revision of the article for important intellectual content: R. Rudavsky, C.E. Pollack, A. Mehrotra.

Final approval of the article: C.E. Pollack, A. Mehrotra.

Provision of study materials or patients: R. Rudavsky.

Obtaining of funding: A. Mehrotra.

Administrative, technical, or logistic support: R. Rudavsky, A. Mehrotra.

Collection and assembly of data: R. Rudavsky, A. Mehrotra.

Ann Intern Med. 2009;151(5):315-320. doi:10.7326/0003-4819-151-5-200909010-00005
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Background: Retail clinics are clinics within a retail store that provide simple acute and preventive care services for a fixed price without an appointment.

Objective: To describe characteristics of retail clinics, including their location, scope of practice, prices, acceptance of insurance, and ownership, and to estimate the proportion of the U.S. population that lives within a short driving distance of such a clinic.

Design: Cross-sectional descriptive study.

Setting: United States.

Participants: All 982 retail clinics operating as of August 2008.

Measurements: Population living within a 5- and 10-minute driving distance of a retail clinic.

Results: In August 2008, 42 operators ran 982 clinics in 33 states; 88.4% were located in urban areas. Nearly half (44%) of all clinics were located in 5 states (Florida, California, Texas, Minnesota, and Illinois). All offered sore throat treatment (average price, $78) and more than 95% offered treatment of skin conditions, immunizations, pregnancy testing, and lipid or diabetes screening. Almost all (97%) accepted private insurance and Medicare fee-for-service (93%). Among 42 clinic operators, 25 are existing health care companies that operate 11% of the clinics, and 3 are for-profit retail chains that operate 73% of the clinics. An estimated 10.6% of the total U.S. and 13.4% of the urban U.S. population lives within a 5-minute driving distance of a retail clinic, whereas 28.7% (total) and 35.8% (urban) live within a 10-minute driving distance.

Limitation: Our inventory of clinics stopped in August 2008 and estimates of proximity are based on 2000 census data.

Conclusion: Retail clinics are positioned to provide immunizations and care for simple acute conditions for a substantial segment of the urban U.S. population.

Primary Funding Source: California Healthcare Foundation.


Grahic Jump Location
Location of retail clinics in the United States.

Each circle represents a Combined Statistical Area (CSA) or Metropolitan Statistical Area (MSA), as defined by the U.S. Office of Management and Budget (www.whitehouse.gov/omb/fedreg/metroareas122700.pdf). The size of the circle is proportional to the number of retail clinics in the CSA or MSA. The 30 CSAs or MSAs with the largest number of clinics are labeled. The circle is mapped at the geographic centroid of the CSA or MSA (for example, Los Angeles is not directly on the coast). The CSAs and MSAs frequently include more than 1 city (for example, San Jose, San Francisco, and Oakland, California, are in 1 CSA). For greater legibility of the map, we list only the largest city in the CSA or MSA (for example, San Jose) as the label. Clinics not located in a CSA or MSA (rural clinics) are shown as a small dot at their actual locations.

Grahic Jump Location




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