Retail clinic versus office setting: do patients choose appropriate providers?

OBJECTIVE: To assess whether health plan members who used retail clinics chose that setting for minor conditions and continued to see other providers for more complex conditions. STUDY DESIGN: Retrospective analysis of claims data in a commercially insured population. METHODS: Health plan enrollment data were used to identify and describe the analysis population. Episode Treatment Groups were used to identify members with chronic conditions and to analyze reasons for retail clinic use, complexity of retail clinic visits, and care for chronic conditions in non-retail clinic settings. Logistic regression was used to study predictors of retail clinic use. RESULTS: Retail clinic users differed significantly from nonusers. The most significant predictors of retail clinic use were age, sex, and proximity to a retail clinic. Episodes of care treated in the retail clinic appeared to be less complex than similar episodes treated in other settings. Chronically ill members who used the retail clinic saw another provider for their chronic condition at rates similar to or higher than those of members who did not use the retail clinic. CONCLUSIONS: Individuals may be able to identify when conditions are minor enough to be treated in a retail clinic and serious enough to be treated by a traditional provider.

The safety of trivalent influenza vaccine among healthy children 6 to 24 months of age.

OBJECTIVE: The objective of this study was to assess the safety of routine trivalent influenza vaccine (TIV) administration among healthy children 6 through 23 months of age, after the Advisory Committee on Immunization Practices recommendation. METHODS: The study was a retrospective case-control study of children receiving TIV in the first 2 seasons after the Advisory Committee on Immunization Practices recommendation. We assessed outcomes in the 42 days after vaccination in a population of 13,383 children. Each case subject was matched, according to age and gender, with 3 control subjects. Hazard ratios were calculated with conditional logistic regression analysis. RESULTS: We found no statistically significantly elevated hazard ratios for the first TIV dose. An elevated risk of pharyngitis was found for children receiving a second TIV dose. No elevated risk of seizure was found. CONCLUSION: These results, for a population of healthy children, showed no medically significant adverse events related to TIV among children 6 to 23 months of age.