Gregory W Kurtzman1, Megha A Keshav2, Nikita P Satish3, Mitesh S Patel4. 1. Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, PCAM 14S-176, Philadelphia, PA 19104, USA. Electronic address: gkurtz@mail.med.upenn.edu. 2. School of Engineering/College of Arts, University of Pennsylvania, Philadelphia, PA, USA. 3. The Wharton School, University of Pennsylvania, Philadelphia, PA, USA. 4. Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, PCAM 14S-176, Philadelphia, PA 19104, USA; The Wharton School, University of Pennsylvania, Philadelphia, PA, USA; Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
Abstract
BACKGROUND: Digital platforms that allow patients to go online or use smartphone applications to view and schedule physician appointments have not been well evaluated. METHODS: We conducted systematic searches for primary care physician appointments in 20 cities using ZocDoc, an online appointment scheduling platform. Availability was determined for three insurance types (self-pay, Medicare, and Medicaid) in states with and without Medicaid expansion. We collected data on physician characteristics, number of appointments available, and distance to clinics. RESULTS: The sample comprised 4150 physician observations across 17 states. Overall, the mean distance to clinic was 8.9 miles (SD: 8.4 miles), mean total number of appointments available within 3 days for the 10 closest physicians was 20.1 (SD: 27.1), and the mean number of physicians available within 5 miles was 5.4 (SD: 6.6). There were no differences in physician characteristics by insurance type. Access to appointments did not differ between Medicare and self-pay. However, compared to self-pay, appointments for Medicaid were further away (Mean difference in miles: 5.4, P < 0.001), and there were fewer physicians available within 5 miles (Mean difference in # of physicians: -4.9, P < 0.001). States that did not adopt Medicaid expansion had fewer appointments within proximity, but this differed similarly across insurance types. CONCLUSIONS: There were a substantial number of available appointments at close distances. However, Medicaid patients had less access to appointments within proximity than self-pay or Medicare patients.
BACKGROUND: Digital platforms that allow patients to go online or use smartphone applications to view and schedule physician appointments have not been well evaluated. METHODS: We conducted systematic searches for primary care physician appointments in 20 cities using ZocDoc, an online appointment scheduling platform. Availability was determined for three insurance types (self-pay, Medicare, and Medicaid) in states with and without Medicaid expansion. We collected data on physician characteristics, number of appointments available, and distance to clinics. RESULTS: The sample comprised 4150 physician observations across 17 states. Overall, the mean distance to clinic was 8.9 miles (SD: 8.4 miles), mean total number of appointments available within 3 days for the 10 closest physicians was 20.1 (SD: 27.1), and the mean number of physicians available within 5 miles was 5.4 (SD: 6.6). There were no differences in physician characteristics by insurance type. Access to appointments did not differ between Medicare and self-pay. However, compared to self-pay, appointments for Medicaid were further away (Mean difference in miles: 5.4, P < 0.001), and there were fewer physicians available within 5 miles (Mean difference in # of physicians: -4.9, P < 0.001). States that did not adopt Medicaid expansion had fewer appointments within proximity, but this differed similarly across insurance types. CONCLUSIONS: There were a substantial number of available appointments at close distances. However, Medicaid patients had less access to appointments within proximity than self-pay or Medicare patients.
Authors: Dina M El-Sherif; Mohamed Abouzid; Mohamed Tarek Elzarif; Alhassan Ali Ahmed; Ashwag Albakri; Mohammed M Alshehri Journal: Healthcare (Basel) Date: 2022-02-18
Authors: Frederick North; Elissa M Nelson; Rebecca J Majerus; Rebecca J Buss; Matthew C Thompson; Brian A Crum Journal: JMIR Med Inform Date: 2021-03-18