Rohrer James E, Bernard Matthew, Naessens James, Furst Joseph, Kircher Kyle, Adamson Steven
Department of Family Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Health Serv Manage Res. 2007 May;20(2):134-9. doi: 10.1258/095148407780744679.
Open-access or advanced-access scheduling, which opens the clinic calendar to patients without requiring them to schedule far in advance of the visit, is being introduced in primary care for the purpose of improving access. None of the evaluations reported to date have measured differences in actual visits that might be associated with different scheduling systems. The purpose of this study was to compare utilization of visits to primary care providers for patients served by an open-access clinic with utilization patterns of patients served at clinics not using open-access scheduling. We hypothesized that the odds that a continuing patient received more than one primary care visit would be greater in the clinic where open-access scheduling was in use than in comparison clinics. Our study provides mixed support for the hypotheses. After adjustment for case mix, stable chronic patients treated in open-access clinics may sometimes have greater odds of receiving two or more preventive care visits. However, these effects do not occur in all clinics, suggesting that other clinic characteristics may overcome the effects of open-access scheduling.
开放预约或提前预约排班，即向患者开放诊所日程安排，而无需他们在就诊前提前很久进行预约，目前正在初级保健中推行，目的是改善就诊机会。迄今为止报告的评估中，没有一项衡量过可能与不同排班系统相关的实际就诊差异。本研究的目的是比较开放预约诊所服务的患者对初级保健提供者的就诊利用率与未采用开放预约排班的诊所服务患者的利用模式。我们假设，在使用开放预约排班的诊所中，连续就诊患者接受不止一次初级保健就诊的几率要高于对照诊所。我们的研究对这些假设提供了不统一的支持。在对病例组合进行调整后，在开放预约诊所接受治疗的稳定慢性病患者有时接受两次或更多次预防性保健就诊的几率可能更高。然而，这些影响并非在所有诊所都出现，这表明其他诊所特征可能会抵消开放预约排班的影响。
