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Even children with pediatricians visit retail clinics

Saturday August 10, 2013
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In a study, parents with established relationships with pediatricians still accessed care for their children at retail clinics, typically located in large chain drugstores, mostly because the clinics were convenient.

Most retail clinics are staffed by nonpediatric nurse practitioners and physician assistants who care for patients 18 months and older with minor illnesses such as ear and throat infections, according to background information in the study, which was published July 22 on the website of JAMA Pediatrics.

"While many patients and health insurance companies positively endorse [retail clinics], professional organizations, including the American Academy of Pediatrics and the American Academy of Family Physicians, have raised concerns about the quality of care provided at RCs and the effect of fragmenting care on patients’ overall health," the authors wrote. They added that the literature regarding retail clinics is limited, and little is known about their use for pediatric care.

Jane M. Garbutt, MB, ChB, of Washington University School of Medicine in St. Louis, and colleagues sought to determine reasons that parents with established relationships with pediatricians used retail clinics for some of their children’s care.

The study at 19 pediatric practices in a Midwestern practice-based research network included 1,484 parents who completed a survey (a 91.9% response rate).

Of the 344 parents (23.2%) who had used retail clinics for their children, 74% first considered going to the pediatrician, but reported choosing a retail clinic because the clinic had more convenient hours (36.6%), no office appointment was available (25.2%), they did not want to bother their pediatrician after hours (15.4%) or they thought the problem was not serious enough (13%).

Visits to retail clinics were most commonly for acute upper respiratory tract illnesses (sore throat, 34.3%; ear infection, 26.2%; and colds or flu, 19.2%), according to the study results.

"Many parents with established relationships with a pediatrician use RCs for themselves and for their children, with some repeatedly choosing the RC instead of an office visit," the authors concluded. "These parents believe RCs provide better access to timely care at hours convenient to the family’s schedule.

"Pediatricians can address concerns about quality of care, duplication of services and disrupted care coordination by working to optimize communication with the RCs themselves, as well as with their patients regarding appropriate management of acute minor illnesses and the role of RCs. They also will need to directly address parents’ need for convenient access to care."

Read the study abstract: http://archpedi.jamanetwork.com/article.aspx?articleid=1714856.


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