Richter Jason P, Downs Lynn, Beauvais Brad, Huynh Peter V, Hamilton Jessica E, Kim Forest, Weigel Fred
Medical Support Squadron Commander, 4th Medical Group, Seymour Johnson AFB, North Carolina (Dr Richter); Army-Baylor University, Fort Sam Houston, Texas (Drs Downs, Kim, and Weigel, Mr Huynh, and Ms Hamilton); Trinity University, San Antonio, Texas (Dr Beauvais). Dr Weigel is now at Lipscomb University, Nashville, Tennessee.
Qual Manag Health Care. 2017 Jan/Mar;26(1):22-28. doi: 10.1097/QMH.0000000000000121.
The relationship between open access and patient satisfaction is mixed. Our study is the first to assess the relationship between open access appointment scheduling and patient satisfaction in the Military Health System (MHS). It is also unique in that we examine both same-day and 24-hour access through a relationship with satisfaction.
We conducted a panel time-series analysis with general estimating equations on the Army population of outpatient facilities (N = 32), with 32 364 957 total observations. Our primary independent variables were the proportion of a facility's appointments within 24 hours and same day from July 2013 to May 2015.
We identified that a higher proportion of same-day appointments is associated with increased patient satisfaction with the ability to see their provider when needed. We did not find the same result when examining access within 24 hours.
Open access appointment scheduling appears to have a greater impact on patient satisfaction with timeliness of care if that appointment is made the same day the patient presents to the facility. Facilities should consider opening more of their schedule to accommodate same-day appointments. This can result in less costly primary care instead of emergency department usage.
开放预约与患者满意度之间的关系复杂。我们的研究首次评估了军事卫生系统（MHS）中开放预约排班与患者满意度之间的关系。此外，我们通过与满意度的关系来研究当日预约和24小时预约，这一点也很独特。
我们使用广义估计方程对陆军门诊设施人群（N = 32）进行了面板时间序列分析，共有32364957个观测值。我们的主要自变量是2013年7月至2015年5月期间设施在24小时内和当日预约的比例。
我们发现，当日预约比例越高，患者对在需要时能够见到医生的满意度越高。在检查24小时内的预约时，我们没有发现同样的结果。
如果预约是在患者就诊当日进行，开放预约排班似乎对患者对医疗及时性的满意度有更大影响。医疗机构应考虑开放更多的排班以容纳当日预约。这可以降低初级保健成本，而不是使用急诊科。
