Journal article
Development of a novel metric of timely care access to primary care services
Health services research, Vol.55(2), pp.301-309
04/01/2020
DOI: 10.1111/1475-6773.13255
PMCID: PMC7080389
PMID: 31943208
Abstract
Objective To develop a model for identifying clinic performance at fulfilling next-day and walk-in requests after adjusting for patient demographics and risk. Data Source Using Department of Veterans Affairs (VA) administrative data from 160 VA primary care clinics from 2014 to 2017. Study Design Using a retrospective cohort design, we applied Bayesian hierarchical regression models to predict provision of timely care, with clinic-level random intercept and slope while adjusting for patient demographics and risk status. Timely care was defined as the provision of an appointment within 48 hours of any patient requesting the clinic & apos;s next available appointment or walking in to receive care. Data Collection/Extraction Methods We extracted 1 841 210 timely care requests from 613 263 patients. Principal Findings Across 160 primary care clinics, requests for timely care were fulfilled 86 percent of the time (range 83 percent-88 percent). Our model of timely care fit the data well, with a Bayesian R-2 of .8. Over the four years of observation, we identified 25 clinics (16 percent) that were either struggling or excelling at providing timely care. Conclusion Statistical models of timely care allow for identification of clinics in need of improvement after adjusting for patient demographics and risk status. VA primary care clinics fulfilled 86 percent of timely care requests.
Details
- Title: Subtitle
- Development of a novel metric of timely care access to primary care services
- Creators
- Adam J. Batten - United States Department of Veterans AffairsMatthew R. Augustine - Icahn School of Medicine at Mount SinaiKarin M. Nelson - University of WashingtonPeter J. Kaboli - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health services research, Vol.55(2), pp.301-309
- Publisher
- Wiley
- DOI
- 10.1111/1475-6773.13255
- PMID
- 31943208
- PMCID
- PMC7080389
- ISSN
- 0017-9124
- eISSN
- 1475-6773
- Number of pages
- 9
- Grant note
- VA Office of Rural Health CIN 13-412 / Health Services Research and Development
- Language
- English
- Date published
- 04/01/2020
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9984360149202771
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