Time to Next Available Appointment as an Access to Care Metric

摘要

Timely access to care is one of six aims for health care sys- tems emphasized in the Institute of Medicine’s influential report Crossing the Quality Chasm . Long wait times for out- patient care are associated with higher likelihood of mortal- ity, and systems that successfully improve access to care start by measuring it. Days until third next available appoint- ment is a metric that describes backlog for appointments by counting the number of days until the third next avail- able appointment on a clinician’s schedule. The metric is widely used by health care systems and in research as a mea- sure of access to care. Third next available is considered a more reliable metric because last-minute cancellations might distort the days until the first or second available. We tested this assumption by comparing the variability over time of days until first, second, third, and fourth available appointments.