Availability of Outpatient Care From Psychiatrists: A Simulated-Patient Study in Three US Cities
Availability of Outpatient Care From Psychiatrists: A Simulated-Patient Study in Three US Cities
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DOI：
10.1176/appi.ps.201400051
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发表时间：
2015-01-01
影响因子：
3.8
通讯作者：
Boyd, J. Wesley
中科院分区：
文献类型：
--
作者：
Malowney, Monica;Keltz, Sarah;Boyd, J. Wesley
目的：该研究调查了美国三个城市的精神科医生的门诊预约情况。方法：调查人员假扮成患者，致电波士顿、休斯顿和芝加哥一家大型保险公司的数据库中列出的360名精神科医生(每个城市N=120人)，试图进行预约。来电者声称有蓝十字蓝盾或医疗保险，或表示他们将自掏腰包(N=120每种付款人类型，在不同城市平均分配)。结果：在第一轮电话中，调查人员能够联系到360名精神病医生中的119名(33%)。在216个无人接听的电话中，36%得到了回复。在两轮拜访后，预约了93名精神科医生(26%)。城市之间有显著差异，但付款人类型之间没有显著差异。结论：无论付款人是谁，在三个城市获得精神科医生的门诊预约都是困难的。结果表明，仅扩大保险覆盖面可能对改善精神病医生的可及性几乎没有作用-或者更糟糕的是，扩大覆盖面可能会进一步超过现有服务的能力。
Objectives: The study examined availability of psychiatrists for outpatient appointments in three U.S. cities.Methods: Posing as patients, investigators called 360 psychiatrists listed in a major insurer's database in Boston, Houston, and Chicago (N=120 per city) and attempted to make appointments. Callers claimed to have Blue Cross Blue Shield or Medicare or said they would pay out of pocket (N=120 per payer type, divided evenly across cities).Results: In round 1 of calling, investigators were able to reach 119 of the 360 psychiatrists (33%). Of 216 unanswered calls, 36% were returned. After two calling rounds, appointments were made with 93 psychiatrists (26%). Significant differences were noted between cities but not between payer type.Conclusions: Obtaining outpatient appointments with psychiatrists in three cities was difficult, irrespective of payer. Results suggest that expanding insurance coverage alone may do little to improve access to psychiatrists-or worse, expansion might further overwhelm the capacity of available services.