Literature DB >> 10736903

How many surgery appointments should be offered to avoid undesirable numbers of 'extras'?

T Kendrick1, S Kerry.   

Abstract

BACKGROUND: Patients seen as 'extras' (or 'fit-ins') are usually given less time for their problems than those in pre-booked appointments. Consequently, long queues of 'extras' should be avoided. AIM: To determine whether a predictable relationship exists between the number of available appointments at the start of the day and the number of extra patients who must be fitted in. This might be used to help plan a practice appointment system.
METHOD: Numbers of available appointments at the start of the day and numbers of 'extras' seen were recorded prospectively in 1995 and 1997 in one group general practice. Minimum numbers of available appointments at the start of the day, below which undesirably large numbers of extra patients could be predicted, were determined using logistic regression applied to the 1995 data. Predictive values of the minimum numbers calculated for 1995, in terms of predicting undesirable numbers of 'extras', were then determined when applied to the 1997 data.
RESULTS: Numbers of extra patients seen correlated negatively with available appointments at the start of the day for all days of the week, with coefficients ranging from -0.66 to -0.80. Minimum numbers of available appointments below which undesirably large numbers of extras could be predicted were 26 for Mondays and four for the other week-days. When applied to 1997 data, these minimum numbers gave positive and negative predictive values of 76% and 82% respectively, similar to their values for 1995, despite increases in patient attendance and changes in the day-to-day pattern of surgery provision between the two years.
CONCLUSION: A predictable relationship exists between the number of available appointments at the start of the day and the number of extras who must be fitted in, which may be used to help plan the appointment system for some years ahead, at least in this relatively stable suburban practice.

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Mesh:

Year:  1999        PMID: 10736903      PMCID: PMC1313391     

Source DB:  PubMed          Journal:  Br J Gen Pract        ISSN: 0960-1643            Impact factor:   5.386


  6 in total

1.  Changes resulting from increasing appointment length: practical and theoretical issues.

Authors:  J L Campbell; J G Howie
Journal:  Br J Gen Pract       Date:  1992-07       Impact factor: 5.386

2.  Long to short consultation ratio: a proxy measure of quality of care for general practice.

Authors:  J G Howie; A M Porter; D J Heaney; J L Hopton
Journal:  Br J Gen Pract       Date:  1991-02       Impact factor: 5.386

3.  Longer booking intervals in general practice: effects on doctors' stress and arousal.

Authors:  A Wilson; P McDonald; L Hayes; J Cooney
Journal:  Br J Gen Pract       Date:  1991-05       Impact factor: 5.386

4.  The effect of an appointment system on demand for medical care.

Authors:  D C Morrell; H S Kasap
Journal:  Int J Epidemiol       Date:  1972       Impact factor: 7.196

5.  Identification of underprivileged areas.

Authors:  B Jarman
Journal:  Br Med J (Clin Res Ed)       Date:  1983-05-28

6.  Do appointment systems work?

Authors:  S Arber; L Sawyer
Journal:  Br Med J (Clin Res Ed)       Date:  1982-02-13
  6 in total
  5 in total

1.  How do general practices manage requests from patients for 'same-day' appointments? A questionnaire survey.

Authors:  M Luthra; M N Marshall
Journal:  Br J Gen Pract       Date:  2001-01       Impact factor: 5.386

2.  Managing patient demand: a qualitative study of appointment making in general practice.

Authors:  M Gallagher; P Pearson; C Drinkwater; J Guy
Journal:  Br J Gen Pract       Date:  2001-04       Impact factor: 5.386

3.  Improving access for patients - a practice manager questionnaire.

Authors:  James G Meade; James S Brown
Journal:  BMC Fam Pract       Date:  2006-06-19       Impact factor: 2.497

4.  A qualitative study of the impact of the implementation of advanced access in primary healthcare on the working lives of general practice staff.

Authors:  Sanjiv Ahluwalia; Maxine Offredy
Journal:  BMC Fam Pract       Date:  2005-09-27       Impact factor: 2.497

5.  Measuring access to primary care appointments: a review of methods.

Authors:  Wendy Jones; Glyn Elwyn; Peter Edwards; Adrian Edwards; Melody Emmerson; Richard Hibbs
Journal:  BMC Fam Pract       Date:  2003-07-07       Impact factor: 2.497

  5 in total

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