Craig Evan Pollack1, Katrina Armstrong. 1. The Robert Wood Johnson Clinical Scholars Program, Leonard Davis Institute of Health Economics, University of Pennsylvania, 1303B Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104, USA. craige@mail.med.upenn.edu
Abstract
BACKGROUND: The extent to which retail clinics provide access to care for underserved populations remains largely unknown. The purpose of this study was to determine whether retail clinics tend to be located in census tracts with higher medical need. METHODS: The locations of retail clinics as of July 1, 2008, were mapped and linked to the 2000 US Census and 2008 Health Resources and Services Administration data. Bivariate analyses and logistic regression models with random effects were used to compare the characteristics of census tracts with and without retail clinics. To determine whether retail clinics followed the underlying distribution of chain stores, the location of clinics conditional on there being a chain store was analyzed in 6 counties. RESULTS: Of the 932 retail clinics, 930 were successfully mapped. Eighteen states had no retail clinics, and 17 states had 25 or more clinics. Within counties with at least 1 retail clinic, census tracts with retail clinics had a lower black population percentage, lower poverty rates, and higher median incomes and were less likely to be medically underserved areas/populations compared with census tracts without retail clinics. Similarly, stores with retail clinics were less likely to be located in medically underserved areas compared with stores without retail clinics. CONCLUSION: Retail clinics are currently located in more advantaged neighborhoods, which may make them less accessible for those most in need.
BACKGROUND: The extent to which retail clinics provide access to care for underserved populations remains largely unknown. The purpose of this study was to determine whether retail clinics tend to be located in census tracts with higher medical need. METHODS: The locations of retail clinics as of July 1, 2008, were mapped and linked to the 2000 US Census and 2008 Health Resources and Services Administration data. Bivariate analyses and logistic regression models with random effects were used to compare the characteristics of census tracts with and without retail clinics. To determine whether retail clinics followed the underlying distribution of chain stores, the location of clinics conditional on there being a chain store was analyzed in 6 counties. RESULTS: Of the 932 retail clinics, 930 were successfully mapped. Eighteen states had no retail clinics, and 17 states had 25 or more clinics. Within counties with at least 1 retail clinic, census tracts with retail clinics had a lower black population percentage, lower poverty rates, and higher median incomes and were less likely to be medically underserved areas/populations compared with census tracts without retail clinics. Similarly, stores with retail clinics were less likely to be located in medically underserved areas compared with stores without retail clinics. CONCLUSION: Retail clinics are currently located in more advantaged neighborhoods, which may make them less accessible for those most in need.
Authors: Dima M Qato; Stacy Tessler Lindau; Rena M Conti; L Philip Schumm; G Caleb Alexander Journal: Pharmacoepidemiol Drug Saf Date: 2010-08 Impact factor: 2.890