Abstract
Background: Little is known about how variation in the scheduled length of primary care visits can impact patients' patterns of health care utilization. Objective: To evaluate how the scheduled length of in-person visits with primary care physicians (PCPs) was associated with PCP and patient characteristics, outpatient utilization, and preventive care receipt. Methods: This retrospective cohort study examined data from a large American academic health system. PCP visit length template was defined as either 15- and 30-min scheduled appointments (i.e. 15/30), or 20- and 40-min scheduled appointments (i.e. 20/40). Results: Of 222 included PCPs, 85 (38.3%) used the 15/30 template and 137 (61.7%) used the 20/40 template. The 15/30 group had higher proportions of male (49.4%, vs. 35.8% in the 20/40 group) and family medicine (37.6% vs. 21.2%) physicians. In adjusted patient-level analysis (N = 238,806), having a 15/30 PCP was associated with 9% more primary care visits (incidence rate ratio [IRR], 1.09; 95% confidence interval [CI], 1.03-1.14), and 8% fewer specialty care visits (IRR, 0.92; 95% CI, 0.86-0.98). PCP visit length template was not associated with significant differences in obstetrics/gynaecology visits, continuity of care, or preventive care receipt. In interaction analyses, having a 15/30 PCP was associated with additional primary care visits among non-Hispanic White patients (IRR, 1.10; 95% CI, 1.04-1.16) but not among non-Hispanic Black patients. Conclusion: PCPs' choices about the scheduled length of in-person visits may impact their patients' specialty care use, and have varying impacts across different racial/ethnic groups.
Original language | English (US) |
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Pages (from-to) | 1002-1009 |
Number of pages | 8 |
Journal | Family practice |
Volume | 41 |
Issue number | 6 |
DOIs | |
State | Published - Dec 1 2024 |
Funding
We wish to thank John Stephen, MPH, who contributed to early stages of data programming and analysis. We thank Jeffrey A. Linder, MD, MPH, for providing helpful feedback during drafting of the manuscript. Funding support was provided by the Northwestern Primary Care Practice Based Research Program (NP3) program at Northwestern University Feinberg School of Medicine. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
Keywords
- cancer screening
- care processes
- continuity of care
- health services research
- preventive care
- primary care
- quality of care
- specialty care
ASJC Scopus subject areas
- General Medicine