Scheduling Metrics: Appointment Availability, Overbooks, and No-Shows/Late Cancellations Over Study Time Periods (Pre-APM, Pre-ACA; Post-APM, Pre-ACA; Post-APM Post-ACA)
| Outcome | Pre-APM | Post-APM | Post-ACA | Relative Rates | |
|---|---|---|---|---|---|
| Post-APM vs Pre-APM | Post-ACA vs Post-APM | ||||
| Proportion of appointment searches indicating same day availability* | |||||
| APM clinics | 0.25 | 0.33 | 0.27 | 1.33 (1.21,1.48) | 0.82 (0.71,0.94) |
| Non-APM comparison clinics | 0.26 | 0.29 | 0.25 | 1.11 (0.97, 1.27) | 0.85 (0.70,1.03) |
| APM vs Non-APM comparison relative ratio | 1.20 (1.02, 1.42) | 0.96 (0.76, 1.22) | |||
| Mean days to 3rd next available appointment† | |||||
| APM clinics | 2.96 | 2.24 | 2.87 | −0.72 (−1.34, −0.11) | 0.63 (0.27, 0.99) |
| Non-APM comparison clinics | 3.96 | 4.23 | 4.66 | 0.27 (−0.51, 1.05) | 0.43 (−1.07, 1.93) |
| APM vs non-APM comparison difference in means | −0.99 (−1.99, 0) | 0.21 (−1.33, 1.75) | |||
| Overbooks per month/per 100 appointment slots | |||||
| APM clinics | 5.29 | 5.55 | 5.83 | 1.05 (0.81, 1.36) | 1.05 (0.8, 1.37) |
| Non-APM comparison clinics | 5.96 | 6.59 | 5.90 | 1.11 (0.83, 1.47) | 0.90 (0.72, 1.12) |
| APM vs non-APM comparison relative rate | 0.95 (0.65, 1.39) | 1.17 (0.83, 1.66) | |||
| No-shows/late cancellation per month per 100 appointment slots* | |||||
| APM clinics | 7.04 | 6.69 | 6.57 | 0.95 (0.84, 1.07) | 0.98 (0.93, 1.04) |
| Non-APM comparison clinics | 5.80 | 5.68 | 5.70 | 0.98 (0.87, 1.1) | 1.00 (0.95, 1.06) |
| APM vs non-APM comparison relative rate | 0.97 (0.82, 1.15) | 0.98 (0.91, 1.06) | |||
APM, Alternative Payment Methodology; ACA, Affordable Care Act.
↵* Proportions were determined from logistic regression models of APM status × month, utilizing a robust sandwich estimator to account for correlations within clinics and were adjusted for percent Hispanic, percent Medicaid insurance and percent of panel in a high needs age group. There were no significant trends in proportion within the pre-period.
↵† Rates were determined from Poisson regression models of APM status × month, utilizing a robust sandwich estimator to account for correlations within clinics and were adjusted for percent Hispanic, percent Medicaid insurance and percent of panel in a high needs age group. There were no significant trends in rates within the pre-period.
‡ There was a positive trend in outcome within the pre-period in APM clinic and a downward trends within the pre-period in comparison clinics.