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[Prior appointment, profile of the patient and accessibility]
D Gómez-Calcerrada1, D Pérez Flores, P Marset Campos
1Departamento de Ciencias Sociosanitarias de la Universidad de Murcia, Centro de Salud de Santa María de Gracia.
Objectives:
To analyse the impact of the prior appointment system on still unevaluated care indicators and how the system connected with other factors affecting access to health care.
Design:
Intervention study.
Setting:
Santa María de Gracia Health Centre in Murcia.
Patients And Other Participants:
831 and 724 patients seen at two general medical clinics at the health centre during the same period in two consecutive years, before and after the start of the prior appointment system.
Interventions:
The start of the prior appointment system. A questionnaire given to patients at the end of their consultation.
Measurements And Main Results:
Variables concerning patients' profiles and habitual conduct, resource use and distribution of waiting and consultation times, and health service use connected to other factors of access to care, were compared for before and after the introduction of the prior appointment system. There were significant differences in the distribution of waiting time, which became shorter (p < 0.01); and consultation time, with an increase in intermediate length and a decrease in extreme times (p < 0.05). Health service use also varied according to distance from the centre and place of residence of the patient: it increased for those living further away (p < 0.01).
Conclusions:
The prior appointment system, over and above a decrease in waiting time and increase in consultation time, meant a rationalisation of both time and health service use dependent on other factors connected with access to health care. The absence of modifications in patients' profiles and in their habitual conduct during the consultation were also confirmed.