Abstract
Background: Population growth, an aging population and the increasing prevalence of chronic disease are projected to increase demand for primary care services in the United States. Objective: Using systems engineering methods, to re-design physician patient panels targeting optimal access and continuity of care. Design: We use computer simulation methods to design physician panels and model a practice's appointment system and capacity to provide clinical service. Baseline data were derived from a primary care group practice of 39 physicians with over 20,000 patients at the Mayo Clinic in Rochester, MN, for the years 2004-2006. Panel design specifically took into account panel size and case mix (based on age and gender). Measures: The primary outcome measures were patient waiting time and patient/clinician continuity. Continuity is defined as the inverse of the proportion of times patients are redirected to see a provider other than their primary care physician (PCP). Results: The optimized panel design decreases waiting time by 44% and increases continuity by 40% over baseline. The new panel design provides shorter waiting time and higher continuity over a wide range of practice panel sizes. Conclusions: Redesigning primary care physician panels can improve access to and continuity of care for patients.
Original language | English (US) |
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Pages (from-to) | 1109-1115 |
Number of pages | 7 |
Journal | Journal of general internal medicine |
Volume | 25 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2010 |
Keywords
- continuity of care
- primary care access
- systems engineering
ASJC Scopus subject areas
- Internal Medicine