The impact of case mix on timely access to appointments in a primary care group practice.
At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number...
| Publicado en: | Health Care Management Science Vol. 16; no. 2; pp. 101 - 119 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jun2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104270356&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104270356 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13869620 BSE jtl: Health Care Management Science issn: 13869620 maglogo: N pubinfo: dt: Jun2013 vid: 16 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104270356 NLM23076360 2012082557 10.1007/s10729-012-9214-y NLM23076360 104270356 ppf: 101 ppct: 18 formats: tig: atl: The impact of case mix on timely access to appointments in a primary care group practice. aug: au: Ozen, Asli Balasubramanian, Hari affil: Department of Mechanical and Industrial Engineering, University of Massachusetts at Amherst, 160 Governors Drive, Amherst, MA, 01003, USA, ozen@ecs.umass.edu. sug: subj: Appointments and Schedules Continuity of Patient Care Group Practice Health Services Accessibility Private Practice Management Diagnosis-Related Groups Minnesota Quality of Health Care Primary Health Care ab: At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number of patients in the panel while composition refers to the case-mix, or the type of patients (older versus younger, healthy versus chronic patients), in the panel. In this paper, we quantify the impact of the size and case-mix on the ability of a multi-provider practice to provide adequate access to its empanelled patients. We use overflow frequency, or the probability that the demand exceeds the capacity, as a measure of access. We formulate problem of minimizing the maximum overflow for a multi-physician practice as a non-linear integer programming problem and establish structural insights that enable us to create simple yet near optimal heuristic strategies to change panels. This optimization framework helps a practice: (1) quantify the imbalances across physicians due to the variation in case mix and panel size, and the resulting effect on access; and (2) determine how panels can be altered in the least disruptive way to improve access. We illustrate our methodology using four test practices created using patient level data from the primary care practice at Mayo Clinic, Rochester, Minnesota. An important advantage of our approach is that it can be implemented in an Excel Spreadsheet and used for aggregate level planning and panel management decisions. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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