Monitoring worksite clinic performance using a cost-benefit tool.
OBJECTIVE
The purpose of this study was to explore the usefulness of continuously assessing the return on investment (ROI) of worksite medical clinics as a means of evaluating clinic performance.


METHODS
Visit data from January 1, 2007, to December 31, 2008, were collected from all the on-site clinics operated for the Pepsi Bottling Group. An average system-wide ROI was calculated from the time of each clinic's opening and throughout the study period. A multivariate linear regression model was used to determine the association of average ROI with penetration/utilization rate and plant size.


RESULTS
A total of 26 on-site clinics were actively running as of December 2008. The average ROI at the time of start up was 0.4, which increased to 1.2 at approximately 4 months and 1.6 at the end of the first year of operation. Overall, it seems that the cost of operating a clinic becomes equal to the cost of similar care purchased in the community (ROI = 1) at approximately 3 months after a clinic's opening and flattens out at the end of the first year. The magnitude of the ROI was closely related to the number of visits (a function of the penetration/utilization rate) and the size of the plant population served.


CONCLUSIONS
Serial monitoring of ROIs is a useful metric in assessing on-site clinic performance and quantifying the effect of new initiatives aimed at increasing a clinic's cost effectiveness.
Tao
Xuguang
X
Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287-1629, USA.
Chenoweth
David
D
Alfriend
Amy S
AS
Baron
David M
DM
Kirkland
Tracie W
TW
Scherb
Jill
J
Bernacki
Edward J
EJ
D002253:Carbonated Beverages; D003362:Cost-Benefit Analysis; D006801:Humans; D007221:Industry; D009786:Occupational Health Services / Q000191:economics*; D017132:Workplace