title: Early return visits by primary care patients: a retail nurse practitioner clinic versus standard medical office care.
abstract: The purpose of this study was to compare return visits made by patients within 2 weeks after using retail nurse practitioner clinics to return visits made by similar patients after using standard medical office clinics. Retail medicine clinics have become widely available. However, their impact on return visit rates compared to standard medical office visits for similar patients has not been extensively studied. Electronic medical records of adult primary care patients seen in a large group practice in Minnesota in 2009 were analyzed for this study. Patients who were treated for sinusitis were selected. Two groups of patients were studied: those who used one of 2 retail walk-in clinics staffed by nurse practitioners and a comparison group who used one of 4 regular office clinics. The dependent variable was a return office visit to any site within 2 weeks. Multiple logistic regression analysis was used to adjust for case-mix differences between groups. Unadjusted odds of return visits were lower for retail clinic patients than for standard office care patients. After adjustment for case mix, patients with more outpatient visits in the previous 6 months had higher odds of return visits within 2 weeks (2-6 prior visits: odds ratio [OR]=1.99, P=0.00; 6 or more prior visits: OR=6.80, P=0.00). The odds of a return visit within 2 weeks were not different by clinic type after adjusting for propensity to use services (OR=1.17, P=0.28). After adjusting for case mix differences, return visit rates did not differ by clinic type.
authors.affiliation: Department of Family Medicine, Mayo Clinic-Rochester, Rochester, Minnesota 55905, USA. rohrer.james@mayo.edu
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Angstman
authors.forename: Gregory
authors.initials: G
authors.lastname: Garrison
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D011320:Primary Health Care / Q000458:organization & administration*; D017149:Private Sector; D020379:Risk Adjustment; D012852:Sinusitis / Q000628:therapy*; D055815:Young Adult