Observational studyJournal of clinical anesthesia2017
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.
Observational study in Journal of clinical anesthesia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
Funding
Abstract
STUDY
objectiveTo determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%.
designRetrospective, observational study using electronic health records.
settingChronic 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.
interventionsOpen-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 7months 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
resultsThe 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 4.7days (95% CI 2.3 to 7.0days, P<0.001) from 14.1days to 9.4days in the new patient group. More new patients were seen within 1week 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.
conclusionsAccess 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.
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