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Related Experiment Videos

Predictors of variation in office visit interval assignment.

Karen B DeSalvo1, Jason P Block, Paul Muntner

  • 1Section of General Internal Medicine, Tulane School of Public Health, Department of Epidemiology, New Orleans, LA 70012, USA. kdesalv@tulane.edu

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|October 7, 2003
PubMed
Summary

Physician characteristics and their subjective patient assessments significantly influence revisit intervals (RVI) for chronic conditions. This variability in RVI impacts patient access to care and requires further research for optimization.

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Area of Science:

  • Internal Medicine
  • Health Services Research
  • Clinical Practice Variation

Background:

  • Ambulatory appointment revisit intervals (RVI) significantly impact patient access to care.
  • Physicians lack formal training in RVI assignment, leading to practice variation.

Purpose of the Study:

  • To determine if vignette-assessed predictors of RVI assignment are also significant in real patient care.
  • To identify key determinants of RVI in ambulatory settings for chronic disease management.

Main Methods:

  • Cross-sectional survey of 59 internal medicine residents and 228 patients with hypertension or diabetes.
  • Hierarchical linear models used to analyze RVI in weeks, considering physician, visit, and patient covariates.

Main Results:

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  • Mean RVI was 12.4 weeks, similar for diabetes and hypertension.
  • Physician identity was the largest contributor (14.7%) to RVI variance.
  • Perceptions of patient stability, compliance, comorbidity, and physician demographics predicted RVI.

Conclusions:

  • Physician characteristics and subjective patient assessments are primary drivers of RVI.
  • Reducing RVI variation is challenging due to limited evidence on optimal intervals for chronic conditions.