Comparison of a community clinic with a hospital out-patient clinic in rheumatology

Community clinics are increasingly advocated as a way of delivering specialist health care. In this study, a hospital-based clinic is compared to a rotating community clinic in terms of descriptive consultation data, patient satisfaction, case mix and cost. Among other things, community clinics were more local (1.6 vs 4.9 miles), involved less waiting for the first appointment (47 vs 27% seen within 1 month), provided longer consultation times (49 vs 31% 20 min appointments) and produced more satisfactory consultations (82 vs 52% said their questions were always answered). Consultation data, however, showed that less patients were seen in the community clinic (8.6 vs 14.1 patients/doctor/clinic), with a higher old/new ratio (6.04 vs 3.96) and the cost per patient was higher (pound 15.93 vs pound 10.35). No differences were found in the case-mix data.