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Journal of General Internal Medicine

, Volume 33, Issue 9, pp 1441–1443 | Cite as

Differences in Primary Care Appointment Availability and Wait Times by Neighborhood Characteristics: a Mystery Shopper Study

  • David Grande
  • Jessica X. Zuo
  • Rathnam Venkat
  • Xinwei Chen
  • Katelyn R. Ward
  • Jane W. Seymour
  • Nandita Mitra
Concise Research Reports

INTRODUCTION

Primary care is widely recognized as a gateway to the health care system and improved health.1 Prior studies have found disparities in appointment access by insurance type2 (commercial vs. Medicaid) and mixed findings on the association of neighborhood socioeconomic status and having a usual source of care.3,4 We previously found large racial differences in the supply of primary care across neighborhoods in a large urban area (Philadelphia, PA).5 In this study, we examine how appointment access varies by neighborhood socio-demographics and primary care supply—hypothesizing less access in low SES neighborhoods and those with lower supply.

METHODS

As previously described, we inventoried adult primary care practices in and near Philadelphia County.5 From July 6 to September 14, 2015, research assistants posing as patients called practices to request a new, non-urgent, appointment.2Medicaid participating practices received private and Medicaid-insured calls. Practices were...

KEY WORDS

primary care access simulated patient primary care supply appointment availability appointment wait times 

Notes

Acknowledgements

The authors thank Daniel Polsky and Karin Rhodes for their contributions to the study design and review of prior versions of the study manuscript and Ashley Beggin for assisting with data analysis and critical revisions of the manuscript.

Compliance with ethical standards

Funding information

Funding for this study was provided by the Independence Foundation in Philadelphia, PA.

Prior presentations

Some preliminary results from this study were presented at 1) the June, 2016 Academy Health Annual Meeting in Boston, MA and 2) the May, 2016 SGIM Annual Meeting in Hollywood, FL.

Conflict of interest

The authors declare that they do not have a conflict of interest.

References

  1. 1.
    Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457–502.CrossRefGoogle Scholar
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    Polsky D, Candon M, Saloner B, Wissoker D, Hempstead K, Kenney GM, Rhodes K. Changes in primary care access between 2012 and 2016 for new patients with Medicaid and private coverage. JAMA Intern Med. 2017;177(4):588–590.CrossRefGoogle Scholar
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    Kirby JB, Kaneda T. Neighborhood socioeconomic disadvantage and access to health care. J Health Soc Behav. 2005;46(1):15–31.CrossRefGoogle Scholar
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    Hussein M DRA, Field RI. Neighborhood socioeconomic status and primary health care: Usual points of access and temporal trends in a major US urban area. J Urban Health. 2016;93(6):1027–1045.CrossRefGoogle Scholar
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    Brown EJ, Polsky D, Barbu CM, Seymour JW, Grande D. Racial Disparities In Geographic Access To Primary Care In Philadelphia. Health Aff (Millwood). 2016;35(8):1374–1381.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • David Grande
    • 1
    • 2
  • Jessica X. Zuo
    • 3
  • Rathnam Venkat
    • 4
  • Xinwei Chen
    • 1
  • Katelyn R. Ward
    • 5
  • Jane W. Seymour
    • 6
  • Nandita Mitra
    • 7
  1. 1.Division of General Internal Medicine, Perelman School of Medicine University of PennsylvaniaPhiladelphiaUSA
  2. 2.Leonard Davis Institute of Health Economics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Wharton SchoolUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.Tufts University School of MedicineBostonUSA
  6. 6.Department of EpidemiologyBoston University School of Public HealthBostonUSA
  7. 7.Department of Biostatistics and Epidemiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA

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