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Open access in primary care: results of a North Carolina pilot project.

Publication ,  Journal Article
Bundy, DG; Randolph, GD; Murray, M; Anderson, J; Margolis, PA
Published in: Pediatrics
July 2005

OBJECTIVE: Appointment delays impede access to primary health care. By reducing appointment delays, open access (OA) scheduling may improve access to and the quality of primary health care. The objective of this pilot study was to assess the potential impact of OA on practice and patient outcomes by using pilot-study data from 4 North Carolina primary care practices. METHODS: We conducted an interrupted time-series pilot study of 4 North Carolina primary care practices (2 family medicine and 2 pediatric practices) participating in a quality-improvement (QI) collaborative from May 2001 to May 2002. The year-long collaborative comprised 25 practices and consisted of three 2-day meetings led by expert faculty, monthly data feedback, and monthly conference calls. Our main outcome measures were appointment delays, appointment no-shows, patient satisfaction, continuity of care, and staff satisfaction during the 12-month study period. RESULTS: Providers in all 4 practices successfully implemented OA. On average, providers reduced their delay to the third available preventive care appointment from 36 to 4 days. No-show rates declined (first quarter [Q1] rate: 16%; fourth quarter [Q4] rate: 11%; no-show reduction: 5% [95% confidence interval: 1%, 10%]), and overall patient satisfaction improved (Q1: 45% rated overall visit quality as excellent; Q4: 61% rated overall visit quality as excellent; change in satisfaction: 16% [95% confidence interval: 0.2%, 30%]). Continuity of care followed a similar pattern of improvement, but the change was not statistically significant. Staff satisfaction neither improved nor declined. CONCLUSIONS: This pilot study suggests that primary care practices can implement OA successfully by using QI-collaborative methods. These results provide preliminary evidence that OA may improve practice and patient outcomes in primary care. These analyses should be repeated in larger groups of practices with longer follow-up.

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Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

July 2005

Volume

116

Issue

1

Start / End Page

82 / 87

Location

United States

Related Subject Headings

  • Quality Assurance, Health Care
  • Primary Health Care
  • Pilot Projects
  • Pediatrics
  • Pediatrics
  • Patient Satisfaction
  • Office Management
  • North Carolina
  • Humans
  • Health Services Accessibility
 

Citation

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Bundy, D. G., Randolph, G. D., Murray, M., Anderson, J., & Margolis, P. A. (2005). Open access in primary care: results of a North Carolina pilot project. Pediatrics, 116(1), 82–87. https://doi.org/10.1542/peds.2004-2573
Bundy, David G., Greg D. Randolph, Mark Murray, John Anderson, and Peter A. Margolis. “Open access in primary care: results of a North Carolina pilot project.Pediatrics 116, no. 1 (July 2005): 82–87. https://doi.org/10.1542/peds.2004-2573.
Bundy DG, Randolph GD, Murray M, Anderson J, Margolis PA. Open access in primary care: results of a North Carolina pilot project. Pediatrics. 2005 Jul;116(1):82–7.
Bundy, David G., et al. “Open access in primary care: results of a North Carolina pilot project.Pediatrics, vol. 116, no. 1, July 2005, pp. 82–87. Pubmed, doi:10.1542/peds.2004-2573.
Bundy DG, Randolph GD, Murray M, Anderson J, Margolis PA. Open access in primary care: results of a North Carolina pilot project. Pediatrics. 2005 Jul;116(1):82–87.

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

July 2005

Volume

116

Issue

1

Start / End Page

82 / 87

Location

United States

Related Subject Headings

  • Quality Assurance, Health Care
  • Primary Health Care
  • Pilot Projects
  • Pediatrics
  • Pediatrics
  • Patient Satisfaction
  • Office Management
  • North Carolina
  • Humans
  • Health Services Accessibility