Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California
Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California
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DOI：
10.1215/03616878-9626866
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发表时间：
2022-06-01
影响因子：
4.2
通讯作者：
Haeder, Simon F.
中科院分区：
文献类型：
--
作者：
Burman, Abigail;Haeder, Simon F.
内容：提供者目录的准确性以及消费者是否能够及时预约是保健服务和结果的关键决定因素。研究方法：我们评估了从加州管理式医疗保健部门获得的准确性和及时访问数据，包括对2018年和2019年加州所有管理式医疗保健计划的初级保健提供者、心脏病学家、内分泌学家和胃肠病学家的大型随机代表性调查的回复。调查结果：调查能够验证提供商目录条目的四个专业的59%至76%的上市或78%至88%的供应商达到。我们发现，消费者能够为28%至54%的列表或44%至72%的准确列出的提供者安排紧急护理预约。对于一般护理预约，百分比范围从35%到64%的上市供应商或51%到87%的准确上市供应商。与准确性相关的市场差异通常很小。Medi-Cal计划在及时获取方面优于其他市场。初级保健始终优于所有其他专业。一般预约的及时就诊率高于紧急护理预约。结论：我们的发现提出了有关监管制度以及消费者获取和健康结果的问题。
Context: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes. Methods: We evaluated accuracy and timely access data obtained from the California Department of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California. Findings: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed other markets with regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments. Conclusions: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.