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The Use and Out-of-Pocket Cost of Urgent Care Clinics and Retail-Based Clinics by Adolescents and Young Adults Compared With Children.

Publication ,  Journal Article
Wong, CA; Bain, A; Polsky, D; Merchant, RM; Antwi, YA; Slap, G; Rubin, D; Ford, CA
Published in: J Adolesc Health
January 2017

PURPOSE: We describe the use and out-of-pocket cost of urgent care clinics (UCCs) and retail-based clinics (RBCs) as ambulatory care alternatives to physician offices among children, adolescents, and young adults, and examine differences in use by age. METHODS: Cross-sectional analysis describing diagnoses and out-of-pocket costs for 8.9 million UCC, RBC, and physician office encounters by privately insured child (aged <11 years), adolescent (aged 11-18 years), and young adult (aged 19-30 years) beneficiaries in a U.S. national administrative data set from January to June 2013. We calculate relative odds (RO) of UCC and RBC utilization by adolescents and young adults, using physician office encounters and children as reference groups. RESULTS: UCC (n = 286,144) and RBC (n = 89,903) visits were <5% of encounters. Upper respiratory infections were the most common diagnosis at UCCs (children 25.2%, adolescents 27.3%, young adults 26.5%) and RBCs (38.1%, 44.1%, 42.0%). The mean out-of-pocket cost was higher for UCCs (children +$38, adolescents +$29, young adults +$25) and lower for RBCs (-$4, -$15, -$18) compared with physician office encounters. For adolescents, the adjusted relative probability of UCC or RBC versus physician office encounters was 9% higher (RO = 1.09, 95% confidence interval [CI] = 1.08-1.10) and 31% higher (RO = 1.31, 95% CI = 1.29-1.34), respectively, compared with children. For young adults, the adjusted relative probability of a UCC or RBC encounter was 54% (RO = 1.54, 95% CI = 1.52-1.55) and 68% (RO = 1.68, 95% CI = 1.65-1.71) higher, respectively. CONCLUSIONS: Adolescents and young adults were more likely to visit RBCs and UCCs than children. Understanding of UCC and RBC use, cost, and quality of care is needed to inform policies on their roles in health care.

Duke Scholars

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Published In

J Adolesc Health

DOI

EISSN

1879-1972

Publication Date

January 2017

Volume

60

Issue

1

Start / End Page

107 / 112

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Public Health
  • Office Visits
  • Male
  • Humans
  • Health Expenditures
  • Female
  • Cross-Sectional Studies
  • Child
 

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Wong, C. A., Bain, A., Polsky, D., Merchant, R. M., Antwi, Y. A., Slap, G., … Ford, C. A. (2017). The Use and Out-of-Pocket Cost of Urgent Care Clinics and Retail-Based Clinics by Adolescents and Young Adults Compared With Children. J Adolesc Health, 60(1), 107–112. https://doi.org/10.1016/j.jadohealth.2016.09.009
Wong, Charlene A., Alexander Bain, Daniel Polsky, Raina M. Merchant, Yaa Akosa Antwi, Gail Slap, David Rubin, and Carol A. Ford. “The Use and Out-of-Pocket Cost of Urgent Care Clinics and Retail-Based Clinics by Adolescents and Young Adults Compared With Children.J Adolesc Health 60, no. 1 (January 2017): 107–12. https://doi.org/10.1016/j.jadohealth.2016.09.009.
Wong CA, Bain A, Polsky D, Merchant RM, Antwi YA, Slap G, et al. The Use and Out-of-Pocket Cost of Urgent Care Clinics and Retail-Based Clinics by Adolescents and Young Adults Compared With Children. J Adolesc Health. 2017 Jan;60(1):107–12.
Wong, Charlene A., et al. “The Use and Out-of-Pocket Cost of Urgent Care Clinics and Retail-Based Clinics by Adolescents and Young Adults Compared With Children.J Adolesc Health, vol. 60, no. 1, Jan. 2017, pp. 107–12. Pubmed, doi:10.1016/j.jadohealth.2016.09.009.
Wong CA, Bain A, Polsky D, Merchant RM, Antwi YA, Slap G, Rubin D, Ford CA. The Use and Out-of-Pocket Cost of Urgent Care Clinics and Retail-Based Clinics by Adolescents and Young Adults Compared With Children. J Adolesc Health. 2017 Jan;60(1):107–112.
Journal cover image

Published In

J Adolesc Health

DOI

EISSN

1879-1972

Publication Date

January 2017

Volume

60

Issue

1

Start / End Page

107 / 112

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Public Health
  • Office Visits
  • Male
  • Humans
  • Health Expenditures
  • Female
  • Cross-Sectional Studies
  • Child