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Comparison of methods based on appointments systems to measure access to primary care |
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| Third appointment [21] |
NEMAS [15] |
Ledlow [14] |
Access Response Index AROS [22] |
Campbell [12] |
Kendrick [13] |
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| Measurement |
The 3rd available routine appointment at 12 midday, one day per week, for every clinician |
Date of patient call and appointment provided. GP requested and GP allocated. |
Appointments demanded but not available in US style primary care clinics compared to community clinics. Demand versus availability gap coded into 4 categories. |
Number of days until next available routine appointment (with any clinician) at 4 pm, every working day |
Number of appointments provided at the beginning of the day and the number still available. Total number of patients seen during the day, noting the number of 'extras' |
Number of appointments available at the start of the day and the number of patients seen as 'extras' at the end of the day |
| Frequency of data collection |
Once a week |
Continuous |
Daily |
Once a day |
Twice a day |
Twice a day |
| Weighted for part time staff |
Yes |
No |
No |
No |
No |
No |
| Named clinician access measured |
Yes |
Yes |
No |
No |
No |
No |
| Data analysis |
Weekly median score and monthly average |
Computerised |
Demand versus availability gap |
Computer to work out 5 day moving average |
Data related to practice list size, with rates given per 1000 patients |
Daily tally |
| Results |
Weekly snapshot of patient access profile |
Complete computerised analysis of practice appointment system |
Feedback reports generated to clinic staff |
Trends across weekly schedules. |
Bar charts represent number of appointments offered versus number of patients seen. Start of day appointment availability categorised as low, medium and high |
Graphical display of extras versus number of free appointments during the day |
| Extent of and reason for use |
Primary Care Collaborative in England. To inform implementation of advanced access |
145 teaching practices Audit |
US Military Clinic Study |
10 practices To inform improvement |
19 practices Research Study |
1 practice Research Study |
| Co-ordination |
National Primary Care Development Team |
Department of General Practice, University of Glasgow. |
Healthcare Programs Central Michigan University. |
University department of General Practice |
University Department of General Practice, Edinburgh. |
Department of Primary Health Care, University of Southampton. |
Jones et al. BMC Family Practice 2003 4:8 doi:10.1186/1471-2296-4-8 |
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