title: Monitoring worksite clinic performance using a cost-benefit tool.
abstract: 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.
authors.affiliation: Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287-1629, USA.
authors.forename: Xuguang
authors.initials: X
authors.lastname: Tao
authors.forename: David
authors.initials: D
authors.lastname: Chenoweth
authors.forename: Amy S
authors.initials: AS
authors.lastname: Alfriend
authors.forename: David M
authors.initials: DM
authors.lastname: Baron
authors.forename: Tracie W
authors.initials: TW
authors.lastname: Kirkland
authors.forename: Jill
authors.initials: J
authors.lastname: Scherb
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bernacki
mesh_terms: D002253:Carbonated Beverages; D003362:Cost-Benefit Analysis; D006801:Humans; D007221:Industry; D009786:Occupational Health Services / Q000191:economics*; D017132:Workplace