title: Quality of care at retail clinics for 3 common conditions.
abstract: OBJECTIVE
  Evaluation of quality of care across retail clinics in a geographically diverse population has not been undertaken to date. We sought to evaluate and compare the quality of care for otitis media, pharyngitis, and urinary tract infection received in retail medical clinics in CVS pharmacies ("MinuteClinics" [MCs]), ambulatory care facilities (ACFs), and emergency departments (EDs).
  
  
  METHODS
  We used 14 measures constructed from RAND Corporation's Quality Assurance Tools and guidelines from the American Academy of Pediatrics, the American Academy of Family Physicians, and the Infectious Diseases Society of America. Our cohort was drawn from Aetna medical and prescription claims, 2009-2012. Members were matched on visit date, condition, and propensity score. Generalized estimating equations were used to compare quality across clinic type, overall, and by index condition.
  
  
  RESULTS
  We matched 75,886 episodes of care, of which 20,153 were eligible for at least 1 quality measure. MCs performed better than EDs and ACFs in 7 measures. In a multivariable model, MCs performed better than ACFs and EDs across all quality measures ([OR 0.42; 95% CI, 0.40-0.45; P < .0001; ACF vs MC] [OR 0.29; 95% CI, 0.27-0.31; P < .0001; ED vs MC]). Results for each condition were significant at P < .0001.
  
  
  CONCLUSIONS
  Quality of care for these conditions based on widely accepted objective measures was superior in MinuteClinics compared with ACFs and EDs.
authors.affiliation: CVS Caremark, 100 Scenic View Rd, Cumberland, RI 02864. E-mail: william.shrank@cvscaremark.com.
authors.forename: William H
authors.initials: WH
authors.lastname: Shrank
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Krumme
authors.forename: Angela Y
authors.initials: AY
authors.lastname: Tong
authors.forename: Claire M
authors.initials: CM
authors.lastname: Spettell
authors.forename: Olga S
authors.initials: OS
authors.lastname: Matlin
authors.forename: Andrew
authors.initials: A
authors.lastname: Sussman
authors.forename: Troyen A
authors.initials: TA
authors.lastname: Brennan
authors.forename: Niteesh K
authors.initials: NK
authors.lastname: Choudhry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000628:therapy*; D010594:Pharmacies / Q000592:standards; D010612:Pharyngitis / Q000628:therapy*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D014552:Urinary Tract Infections / Q000628:therapy*; D055815:Young Adult