Full Citation
Title: Retail Health Clinics: Endogenous Location Choice and Emergency Department Diversion
Citation Type: Miscellaneous
Publication Year: 2014
ISBN:
ISSN:
DOI:
NSFID:
PMCID:
PMID:
Abstract: Over 20% of Americans do not have adequate access to primary care services due to a lack of available physicians (HRSA, 2014). In response many have called for an increased role of the Nurse Practitioner. The retail health clinic, a recent innovation, is well suited to serve as a conduit for this expanded role. In this paper, I examine retail health clinics by estimating the determinants of clinic location choice and by evaluating their impact on unnecessary visits to nearby emergency departments (EDs). First, I construct a structural discrete choice model of clinic location that accounts for both demand and competition effects. This model incorporates a rich error structure that allows for spatial correlation and market level unobservable heterogeneity. I find that clinics are more likely to locate in areas that are populous, wealthy, educated, and white, and that they are less likely to locate in traditionally under-served communities. Second, I combine the results of my predictive model with data on ED visits to determine if clinics help direct patients away from receiving treatment at expensive emergency rooms. I find that access to retail clinics causes a substantial decrease in the number of ED visits for bronchitis and upper respiratory infections. The savings associated with retail clinic induced ED diversion is conservatively estimated to be at least $88 million in 2012 alone. In California, counterfactual analysis suggests that relaxing the barriers to clinic entry would result in $10.5 million in annual health care savings.
User Submitted?: No
Authors: Hollingsworth, Alex
Publisher: University of Arizona
Data Collections: IPUMS NHGIS
Topics: Health, Land Use/Urban Organization, Other
Countries: