Table 1 Comparison of methods based on appointments systems to measure access to primary care
From: Measuring access to primary care appointments: a review of methods
| Â | Third appointment [21] | NEMAS [15] | Ledlow [14] | Access Response Index AROS [22] | Campbell [12] | Kendrick [13] |
|---|---|---|---|---|---|---|
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. |