Public health analysts trying to compare use of different types of care may need access to better types of provider databases.
Grant Martsolf, a Pittsburgh-based researcher affiliated with the Rand Corp., and colleagues talk about provider location data concerns in a new research paper on the effects of retail health care clinics on people’s use of nearby emergency rooms.
In the paper, which was published in the Annals of Emergency Medicine, the researchers looked at the possibility that increased access to clinics in drug stores, discount stores and other retail locations might cut patients’ use of emergency rooms for minor ailments, such as sore throats.
The researchers looked at emergency room use in communities with easy access to retail clinics. The researchers found, to their surprise, that an increase in retail clinic penetration appeared to have little or no effect on emergency room use.
But the researchers noted that they need better sources of data to make sure they understand how the opening and closing of different types of health care provider locations affects use of emergency room care.
The researchers were able to get emergency room data from the Healthcare Cost and Utilization Protect State Emergency Department Databases, and they were able to get retail walk-in clinic addresses from Merchant Medicine, a research firm. They weren’t able to get the same kind of location information for urgent care clinics outside of retail stores, and they weren’t able to get location information for traditional primary care doctors’ offices.
If most of the new retail clinics and urgent care clinics are opening in high-income areas, rather than in low-income areas or other areas where people have a hard time getting health care outside the emergency room, that might explain why an increase in the number of retail clinics in a community had little effect on emergency room use, the researchers say.
The researchers also present a table showing that, even though Medicare enrollees are over 65, disabled or getting kidney dialysis, they are only about one-quarter as likely as Medicaid enrollees to visit an emergency room for minor ailments.
Uninsured people and people with commercial insurance are about equally likely to visit an emergency room for minor ailments. They are twice as likely to use an emergency room for frivolous reasons as Medicare patients are, but they are only half as likely to make frivolous use of an emergency room as Medicaid patients are.
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