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Related Experiment Videos

Physician practice variation in assignment of return interval.

K B DeSalvo1, B E Bowdish, A S Alper

  • 1Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA. kdesalv@mailhost.tcs.tulane.edu

Archives of Internal Medicine
|January 27, 2000
PubMed
Summary

Primary care physicians show significant variability in scheduling patient follow-up appointments. Factors like patient stability and ordering tests influence revisit intervals, with female physicians tending to schedule earlier returns.

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Area of Science:

  • Ambulatory care research
  • Healthcare management
  • Physician behavior studies

Background:

  • Capitation reimbursement models necessitate understanding primary care physician (PCP) appointment scheduling.
  • Prior research indicates substantial variability in PCP appointment assignment practices.

Purpose of the Study:

  • To investigate factors influencing patient revisit interval assignments in ambulatory care settings.
  • To identify determinants of follow-up appointment scheduling by primary care physicians.

Main Methods:

  • A survey was administered to 62 internal medicine providers regarding hypothetical diabetic and hypertensive patient scenarios.
  • Data collected included provider demographics and practice style variables, such as therapy changes, test ordering, and recommended return intervals.

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  • Statistical analysis examined influences on appointment scheduling decisions.

    • Main Results:

    • A high response rate of 89% (56 providers) was achieved.
    • Significant variation in recommended return intervals was observed, ranging from 2.2 to 20.5 weeks.
    • Patient stability, decisions to change therapy, and ordering tests were significant predictors of earlier return appointments. Female providers assigned shorter revisit intervals.

    Conclusions:

    • Considerable variation exists in follow-up appointment scheduling among physicians with similar backgrounds.
    • Patient stability is a primary driver of revisit interval decisions.
    • Test-ordering practices may lead to inefficient appointment use; provider sex influences scheduling and warrants further study.