Modified open-access scheduling for new patient evaluations at an academic chronic pain clinic increased patient access to care, but did not materially reduce their mean cancellation rate: A retrospective, observational study

Autor: Richard H. Epstein, Chaturani T. Ranasinghe, David A. Lubarsky, Eellan Sivanesan, Constantine D. Sarantopoulos
Rok vydání: 2017
Předmět:
Adult
medicine.medical_specialty
Clinical Sciences
Psychological intervention
Pilot Projects
Article
Scheduling (computing)
Pain clinics
Hospital
Appointments and Schedules
03 medical and health sciences
0302 clinical medicine
Clinical Research
Anesthesiology
030202 anesthesiology
medicine
Humans
Electronic Health Records
030212 general & internal medicine
health care economics and organizations
Retrospective Studies
Academic Medical Centers
business.industry
Chronic pain clinic
Health services accessibility
Pain Research
Chronic pain
Retrospective cohort study
Anesthesia Department
medicine.disease
United States
Confidence interval
Good Health and Well Being
Anesthesiology and Pain Medicine
Pain Clinics
Physical therapy
Observational study
Chronic Pain
Anesthesia Department
Hospital
business
Zdroj: Journal of Clinical Anesthesia. 41:92-96
ISSN: 0952-8180
Popis: STUDY OBJECTIVE: To determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%. DESIGN: Retrospective, observational study using electronic health records. SETTING: Chronic pain clinic of an academic anesthesia department. PATIENTS: All patients scheduled for evaluation or follow-up appointments in the chronic pain clinic between April 1, 2014, and December 31, 2015. INTERVENTIONS: Open-access scheduling was instituted in April 2015 with appointments offered on a date of the patient’s choosing ≥1 business day after calling, with no limit on the daily number of new patients. MEASUREMENTS: Mean cancellation rates for new patients were compared between the 12-month baseline period prior to and for 7 months after the change, following an intervening 2-month washout period. The method of batch means (by month) and the 2-sided Student t-test were used; P < 0.01 required for significance. MAIN RESULTS: The new patient mean cancellation rate decreased from a baseline of 35.7% by 4.2% (95% confidence interval [CI] 1.4% to 6.9%; P=0.005); however, this failed to reach the 50% reduction target of 17.8%. Appointment lag time decreased by 4.7 days (95% CI 2.3 to 7.0 days, P < 0.001) from 14.1 days to 9.4 days in the new patient group. More new patients were seen within 1 week compared to baseline (50.6% versus 19.1%; P < 0.0001). The mean number of new patient visits per month increased from 158.5 to 225.0 (P=0.0004). The cancellation rate and appointment lag times did not decrease for established patient visits, as expected because open-access scheduling was not implemented for this group. CONCLUSIONS: Access to care for new chronic pain patients improved with modified open-access scheduling. However, their mean cancellation rate only decreased from 35.7% to 31.5%, making this a marginally effective strategy to reduce cancellations.
Databáze: OpenAIRE
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