Abstract
BackgroundAccessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments. Secondary objectives were to assess patient satisfaction and reduction of no-show rates.MethodsWe searched multiple databases, including: Medline via Ovid SP (1947 to present), Embase (from 1980 to present), PsychINFO (from 1806 to present), Cochrane Central Register of Controlled Trials (CENTRAL; all dates), Cumulative Index to Nursing and Allied Health (CINAHL; 1937 to present), and Pubmed (all dates) to identify studies that reported outcomes associated with interventions designed to reduce wait times for primary care appointments. Two independent reviewers assessed all identified studies for inclusion using pre-defined inclusion/exclusion criteria and a multi-level screening approach. Our study methods were guided by the Cochrane Handbook for Systematic Reviews of Interventions.ResultsOur search identified 3,960 articles that were eligible for inclusion, eleven of which satisfied all inclusion/exclusion criteria. Data abstraction of included studies revealed that open access scheduling is the most commonly used intervention to reduce wait times for primary care appointments. Additionally, included studies demonstrated that dedicated telephone calls for follow-up consultation, presence of nurse practitioners on staff, nurse and general practitioner triage, and email consultations were effective at reducing wait times.ConclusionsTo our knowledge, this is the first study to systematically review and identify interventions designed to reduce wait times for primary care appointments. Our findings suggest that open access scheduling and other patient-centred interventions may reduce wait times for primary care appointments. Our review may inform policy makers and family healthcare providers about interventions that are effective in offering timely access to primary healthcare.
Highlights
Accessibility and availability are important characteristics of efficient and effective primary healthcare systems
In 2012, the Canadian Foundation for Healthcare Improvement reported that Canada had a higher percentage of sick adults (23%) who indicated waiting six or more days for a primary care appointment compared to Switzerland (2%) and New Zealand (5%) [6]
Studies not identifying an intervention designed for the purpose of reducing wait times for primary care appointments were not included in this review
Summary
Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. Access to primary healthcare is associated with improved health outcomes and contributes to cost control CFP Canada [1, 2]. Having timely access to primary care has been shown to increase patient satisfaction as well as the quality of care delivered [5]. National surveys have shown that Canadians struggle to schedule same-day appointments with their family physician and subsequently often rely on urgent care for non-urgent health issues [8]
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