Open Access in Primary Care

One important barrier to primary health care access for children is difficulty obtaining timely appointments. Open Access (OA) scheduling is an appointment system designed to reduce appointment delays. This study looked at the impact of OA on access to and the quality of primary health care. The authors conducted a pilot study of four North Carolina primary care practices (two pediatric and two family medicine) participating in a larger year-long quality improvement collaborative. They looked primarily at appointment delays, no-shows, patient satisfaction, continuity of care and staff satisfaction, finding that:

  • Mean appointment delay was reduced by 89 percent for the 30 providers with complete data.
  • No-shows decreased by almost one-third during the intervention.
  • Overall patient satisfaction increased significantly.

These results are consistent with previous case reports that suggest that OA is both feasible and effective for improving access to and quality of care in primary care practices. The most important limitation of this study is that it involved a small sample of practices from a limited geographic area. The positive outcomes indicate the need for further studies with larger groups of practices, control groups and longer follow-up.