Improving nonattendance rates among pediatric patients with Medicaid or private insurance.


Journal

Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 29 09 2018
revised: 08 01 2019
accepted: 01 02 2019
pubmed: 17 2 2019
medline: 21 12 2019
entrez: 17 2 2019
Statut: ppublish

Résumé

Access to dermatologists is low among Medicaid-insured patients. Higher clinic nonattendance among Medicaid-insured patients might affect provider decisions to accept these patients. To determine the effect of different scheduling policies on the attendance among children seen at a pediatric dermatology clinic. In this retrospective review, we compared nonattendance among children for 3 different scheduling policies implemented over 3 consecutive years. The scheduling policies used were a first-available open scheduling policy, a 2-week in advance scheduling policy, and a 4-week in advance scheduling policy. Subset analyses were performed by clinic location and insurance type. The interval between scheduling and appointment date was directly related to nonattendance rates; rates were higher for Medicaid-insured than privately insured patients. Open scheduling was associated with a 37% nonattendance rate for Medicaid-insured patients and 18% nonattendance rate for privately insured patients. A 4-week in advance scheduling policy significantly decreased the nonattendance rate to 19% among Medicaid-insured and 7% among privately insured patients. A 2-week in advance policy further decreased the nonattendance rate to 11% among Medicaid-insured patients and 4% among privately insured patients. This is a retrospective study, and same-day cancellations were not tracked. Decreasing the time interval between scheduling and appointment dates can significantly decrease nonattendance. This strategy might help dermatologists incorporate more Medicaid-insured patients into their practices.

Sections du résumé

BACKGROUND BACKGROUND
Access to dermatologists is low among Medicaid-insured patients. Higher clinic nonattendance among Medicaid-insured patients might affect provider decisions to accept these patients.
OBJECTIVE OBJECTIVE
To determine the effect of different scheduling policies on the attendance among children seen at a pediatric dermatology clinic.
METHODS METHODS
In this retrospective review, we compared nonattendance among children for 3 different scheduling policies implemented over 3 consecutive years. The scheduling policies used were a first-available open scheduling policy, a 2-week in advance scheduling policy, and a 4-week in advance scheduling policy. Subset analyses were performed by clinic location and insurance type.
RESULTS RESULTS
The interval between scheduling and appointment date was directly related to nonattendance rates; rates were higher for Medicaid-insured than privately insured patients. Open scheduling was associated with a 37% nonattendance rate for Medicaid-insured patients and 18% nonattendance rate for privately insured patients. A 4-week in advance scheduling policy significantly decreased the nonattendance rate to 19% among Medicaid-insured and 7% among privately insured patients. A 2-week in advance policy further decreased the nonattendance rate to 11% among Medicaid-insured patients and 4% among privately insured patients.
LIMITATIONS CONCLUSIONS
This is a retrospective study, and same-day cancellations were not tracked.
CONCLUSION CONCLUSIONS
Decreasing the time interval between scheduling and appointment dates can significantly decrease nonattendance. This strategy might help dermatologists incorporate more Medicaid-insured patients into their practices.

Identifiants

pubmed: 30771420
pii: S0190-9622(19)30273-7
doi: 10.1016/j.jaad.2019.02.018
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

412-416

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Sofia B Chaudhry (SB)

Department of Dermatology at Saint Louis University School of Medicine, Saint Louis, Missouri. Electronic address: sofia.chaudhry@health.slu.edu.

Elaine Siegfried (E)

Department of Pediatric Dermatology at Cardinal Glennon Hospital at Saint Louis University School of Medicine, Saint Louis, Missouri.

Umar A Sheikh (UA)

Saint Louis University School of Medicine, Saint Louis, Missouri.

Cassandra Simonetta (C)

Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Niraj Butala (N)

Kaiser Permanente, Lancaster, California.

Eric Armbrecht (E)

Saint Louis University Center for Outcomes Research, Saint Louis, Missouri.

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