Accessibility and Barriers to Oncology Appointments at 40 National Cancer Institute-Designated Comprehensive Cancer Centers: Results of a Mystery Shopper Project
Accessibility and Barriers to Oncology Appointments at 40 National Cancer Institute-Designated Comprehensive Cancer Centers: Results of a Mystery Shopper Project
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DOI：
10.1200/jop.2016.014159
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发表时间：
2016-10-01
影响因子：
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通讯作者：
Kamal, Arif H.
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文献类型：
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作者：
Hamlyn, Geoffrey S.;Hutchins, Kathryn E.;Kamal, Arif H.
目的：患者转向美国国家癌症研究所（NCI）指定的综合癌症中心，因为他们认为那里的治疗质量更好、更及时。然而，最近的研究发现，不同机构的患者可能很难获得预约或从服务员那里获得一致的信息。我们的研究采用神秘购物者的形式来识别和量化患者在40个nci指定的综合癌症中心的同质样本中寻求首次咨询预约时面临的障碍。方法五名神秘顾客使用标准化的电话脚本询问首次可预约的时间和服务项目。结果：当查询第一次可用预约的日期时，29%的呼叫者在没有注册到中心数据库的情况下无法获得估计日期，51%的呼叫者能够获得估计日期，20%的呼叫者可以获得实际日期。在首次可预约的估计或实际日期中，74%的时间超过一周。在不同保险类型或美国地区的预约可用性之间没有统计学上的显著差异。结论我们的研究突出了获取预约信息的困难。虽然没有统计上的显著性，但关于医疗补助患者首次可用预约的查询结果比私人保险患者的估计或实际等待时间更长，医疗补助购物者注意到定性差异。尽管我们的研究受到样本量小和分析方法不完善的限制，但我们的结果表明，我们国家的顶级癌症中心需要为患者提供更有效和更容易获得的护理。
PurposePatients turn to National Cancer Institute (NCI) -designated comprehensive cancer centers because of perceived better quality and more timely access to care. However, recent studies have found that patients at various institutions may struggle to gain access to an appointment or obtain consistent information from attendants. Our study employs a mystery shopper format to identify and quantify barriers faced by patients seeking to make a first consultation appointment across a homogenous sample of 40 NCI-designated comprehensive cancer centers.MethodsFive mystery shoppers used a standardized call script to inquire about first available appointment times and service offerings.ResultsWhen inquiring about a date for a first available appointment, 29% of callers were unable to secure an estimated date without registering into the center's database, 51% were able to secure an estimated date, and 20% were provided with an actual date. Of estimated or actual dates for a first available appointment, 74% were greater than 1 week away. There was no statistically significant variation between appointment availability across insurance type or US region.ConclusionOur study highlights the difficulty of accessing information about appointment availability. Although not statistically significant, inquiries regarding first available appointments for Medicaid patients resulted in longer estimated or actual wait times than those for patients with private insurance, and Medicaid shoppers noted qualitative differences. Although our study was limited by small sample size and imperfect analytic methods, our results suggest the need for more efficient and accessible care for patients at our nation's top cancer centers.