Recommended clinical preventive services are not being delivered despite well-documented benefits. Here we show that transferring simple and repetitive preventive services to nurse-staffed retail clinics provides an opportunity for dramatically improving their delivery. For each of 35 high-benefit, cost-effective preventive services, we identify required training, number of repetitions, and time and cost for full coverage in the US. We determine that full delivery through physician-based practices would require an unrealistic 400,000 full-time personnel. We estimate the efficiency gains from implementation at nurse-staffed clinics at retail locations for 28 services. Widespread adoption would result in a five-fold reduction in variable costs and three-fold reduction in personnel. By elevating the benefit-to-cost ratio, retail implementation can expedite widespread prevention coverage and help transform US healthcare.
@article{arxiv.1207.0029,
title = {Opportunities in Delivery of Preventive Services in Retail Settings},
author = {Yaneer Bar-Yam and Dion Harmon and Keith Nesbitt and May Lim and Suzanne Smith and Bradley A. Perkins},
journal= {arXiv preprint arXiv:1207.0029},
year = {2012}
}