Appointment wait-times and arrival for patients at a low-barrier access addiction clinic

Same-day or next-day access to outpatient medication for addiction treatment (MAT) for both alcohol and opioid use disorders may facilitate sustained treatment with evidence-based therapies for substance use disorders (SUD). This study evaluates the association between appointment wait-times and odds of arrival to appointment for patients seeking outpatient MAT.

The study sample consisted of patients who scheduled an appointment with a low-barrier access addiction clinic between August 1, 2016, and July 31, 2017. The outcome of interest was the status of the appointment as a dichotomous variable: arrive or no-show/cancel. The primary independent variable (wait-time) was the number of overnights between the date a patient scheduled a clinic appointment and the date of service, categorized as 0 days, 1 day, and 2+ days. We conducted bivariable and multivariable logistic regressions to calculate unadjusted and adjusted odds ratios for arrival. Multivariable analyses were adjusted for gender, age, distance of residence from the clinic, and insurance type.

Our analysis included 657 patients, of whom 410 (62%) arrived to their first appointment. Among the 657 patients, 47% (308) were scheduled the same day (0 days) and 82% (252) of them were seen, 23% (151) waited 1 day (next-day) and 53% (80) of them were seen, and 30% (198) waited 2+ days and 39% (78) of them were seen. Patients were more likely to be seen when they had a same-day (OR 6.9 [95% CI 4.6-10.4]; AOR 7.5 [4.9-11.4]) or next-day (OR 1.7 [1.1-2.7]; AOR 1.7 [1.1-2.6]) appointment compared to waiting 2+ days.

Patients seeking MAT through a clinic that schedules same-day and next-day appointments for treatment are more likely to attend addiction appointments compared to patients who wait longer. Clinics should strive to reduce wait-times for patients seeking MAT.