Impact of advanced access on access, workload, and continuity: Controlled before-and-after and simulated-patient study

Salisbury, C; Montgomery, AA; Simons, L; Sampson, F; Edwards, S; Baxter, H; Goodall, S; Smith, H; Lattimer, V; Pickin, DM

Impact of advanced access on access, workload, and continuity: Controlled before-and-after and simulated-patient study

Salisbury, C Montgomery, AA Simons, L Sampson, F Edwards, S Baxter, H Goodall, S

Smith, H Lattimer, V Pickin, DM

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Publication Type:: Journal Article
Citation:: British Journal of General Practice, 2007, 57 (541), pp. 608 - 614
Issue Date:: 2007-08-01

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Field	Value	Language
dc.contributor.author	Salisbury, C	en_US
dc.contributor.author	Montgomery, AA	en_US
dc.contributor.author	Simons, L	en_US
dc.contributor.author	Sampson, F	en_US
dc.contributor.author	Edwards, S	en_US
dc.contributor.author	Baxter, H	en_US
dc.contributor.author	Goodall, S https://orcid.org/0000-0001-6611-6565	en_US
dc.contributor.author	Smith, H	en_US
dc.contributor.author	Lattimer, V	en_US
dc.contributor.author	Pickin, DM	en_US
dc.date.issued	2007-08-01	en_US
dc.identifier.citation	British Journal of General Practice, 2007, 57 (541), pp. 608 - 614	en_US
dc.identifier.issn	0960-1643	en_US
dc.identifier.uri	http://hdl.handle.net/10453/4414
dc.description.abstract	Background: Case studies from the US suggest that Advanced Access appointment systems lead to shorter delays for appointments, reduced workload, and increased continuity of care. Aim: To determine whether implementation of Advanced Access in general practice is associated with the above benefits in the UK. Design of study: Controlled before-and-after and simulated-patient study. Setting: Twenty-four practices that had implemented Advanced Access and 24 that had not. Method: Anonymous telephone calls were made monthly to request an appointment. Numbers of appointments and patients consulting were calculated from practice records. Continuity was determined from anonymised patient records. Results: The wait for an appointment with any doctor was slightly shorter at Advanced Access practices than control practices (mean 1.00 day and 1.87 days respectively, adjusted difference -0.75; 95% confidence interval [CI] = -1.51 to 0.004 days). Advanced Access practices met the NHS Plan 48-hour access target on 71% of occasions and control practices on 60% of occasions (adjusted odds ratio 1.61; 95% CI = 0.78 to 3.31; P = 0.200). The number of appointments offered, and patients seen, increased at both Advanced Access and control practices over the period studied, with no evidence of differences between them. There was no difference between Advanced Access and control practices in continuity of care (adjusted difference 0.003; 95% CI = -0.07 to 0.07). Conclusion: Advanced Access practices provided slightly shorter waits for an appointment compared with control practices, but performance against NHS access targets was considerably poorer than officially reported for both types of practice. Advanced Access practices did not have reduced workload or increased continuity of care. © British Journal of General Practice.	en_US
dc.relation.ispartof	British Journal of General Practice	en_US
dc.subject.classification	Public Health	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Questionnaires	en_US
dc.subject.mesh	Case-Control Studies	en_US
dc.subject.mesh	Family Practice	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Patient Simulation	en_US
dc.subject.mesh	Appointments and Schedules	en_US
dc.subject.mesh	Waiting Lists	en_US
dc.subject.mesh	Workload	en_US
dc.subject.mesh	Patient Satisfaction	en_US
dc.subject.mesh	Continuity of Patient Care	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Surveys and Questionnaires	en_US
dc.title	Impact of advanced access on access, workload, and continuity: Controlled before-and-after and simulated-patient study	en_US
dc.type	Journal Article
utslib.citation.volume	541	en_US
utslib.citation.volume	57	en_US
utslib.for	111702 Aged Health Care	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	541	en_US
pubs.publication-status	Published	en_US
pubs.volume	57	en_US

Abstract:

Background: Case studies from the US suggest that Advanced Access appointment systems lead to shorter delays for appointments, reduced workload, and increased continuity of care. Aim: To determine whether implementation of Advanced Access in general practice is associated with the above benefits in the UK. Design of study: Controlled before-and-after and simulated-patient study. Setting: Twenty-four practices that had implemented Advanced Access and 24 that had not. Method: Anonymous telephone calls were made monthly to request an appointment. Numbers of appointments and patients consulting were calculated from practice records. Continuity was determined from anonymised patient records. Results: The wait for an appointment with any doctor was slightly shorter at Advanced Access practices than control practices (mean 1.00 day and 1.87 days respectively, adjusted difference -0.75; 95% confidence interval [CI] = -1.51 to 0.004 days). Advanced Access practices met the NHS Plan 48-hour access target on 71% of occasions and control practices on 60% of occasions (adjusted odds ratio 1.61; 95% CI = 0.78 to 3.31; P = 0.200). The number of appointments offered, and patients seen, increased at both Advanced Access and control practices over the period studied, with no evidence of differences between them. There was no difference between Advanced Access and control practices in continuity of care (adjusted difference 0.003; 95% CI = -0.07 to 0.07). Conclusion: Advanced Access practices provided slightly shorter waits for an appointment compared with control practices, but performance against NHS access targets was considerably poorer than officially reported for both types of practice. Advanced Access practices did not have reduced workload or increased continuity of care. © British Journal of General Practice.

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http://hdl.handle.net/10453/4414