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Opportunities in Delivery of Preventive Services in Retail Settings

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New England Complex Systems Institute
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See also:

A Complex Systems Science Approach to Healthcare Costs and Quality

NECSI healthcare research page

Figure 2. Personnel requirements for fully delivering clinical preventive services in the current healthcare provider setting Figure 2. Personnel requirements for fully delivering clinical preventive services in the current healthcare provider setting Wired How Complexity Science Could Help Fix Health Care
by Brandon Keim

Cite as: Y. Bar-Yam, D. Harmon, K. Nesbitt, M. Lim, S. Smith, B.A. Perkins, Opportunities in Delivery of Preventive Services in Retail Settings, Handbook of Systems and Complexity in Health (Springer, 2013): 879-887.

Abstract

In the US, 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.

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