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Publications
  • December 2021
  • Article
  • Journal of General Internal Medicine

Primary Care Access During the COVID-19 Pandemic: a Simulated Patient Study

By: Michael Anne Kyle, Renuka Tipirneni, Nitya Thakore, Sneha Dave and Ishani Ganguli
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Abstract

Background
Primary care practices have experienced major strains during the COVID-19 pandemic, such that patients newly seeking care may face potential barriers to timely visits.
Objective
To quantify availability and wait times for new patient appointments in primary care and to describe how primary care practices are guiding patients with suspected COVID-19.
Design
Trained callers conducted simulated patient calls to 800 randomly sampled primary care practices between September 14, 2020, and September 28, 2020.
Participants
We extracted complete primary care physician listings from large commercial insurance networks in four geographically dispersed states between September 10 and 14, 2020 (n=11,521). After excluding non-physician providers and removing duplicate phone numbers, we identified 2705 unique primary care physician practices from which we randomly sampled 200 practices in each region.
Main Measures
Primary care appointment availability, median wait time in days, and practice guidance to patients suspecting COVID-19 infection.
Key Results
Among 56% of listed practices that had accurate contact information listed in the directory, 84% offered a new patient in-person or virtual appointment. Median wait time was 10 days (IQR 3–26 days). The most common guidance in case of suspected COVID-19 was clinician consultation, which was offered in 41% of completed calls. Callers were otherwise directed to on-site testing (14%), off-site testing (24%), a COVID-19 hotline (8%), or an urgent care/emergency department (12%), while 2% of practices had no guidance to offer.
Conclusions
Despite resource constraints, most reachable primary care practices offered timely new patient appointments as well as direct COVID-19 care. Pandemic mitigation strategies should account for and support the central role of primary care practices in the community-based pandemic response.

Keywords

COVID-19; Ambulatory Care; Policy/economics; Access; Telemedicine; Health Pandemics; Health Care and Treatment

Citation

Kyle, Michael Anne, Renuka Tipirneni, Nitya Thakore, Sneha Dave, and Ishani Ganguli. "Primary Care Access During the COVID-19 Pandemic: a Simulated Patient Study." Journal of General Internal Medicine 36, no. 12 (December 2021): 3766–3771.
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More from the Authors

    • August 2021
    • Medical Care Research and Review

    A Mixed Methods Study of Change Processes Enabling Effective Transition to Team-based Care

    By: Michael Anne Kyle, Emma-Louise Aveling and Sara J. Singer
    • Spring 2020
    • MIT Sloan Management Review

    Establishing High Performing Teams: Lessons from Health Care

    By: Michael Anne Kyle, Emma-Louise Aveling and Sara J. Singer
    • American Journal of Managed Care

    Spending Variation Among ACOs in the Medicare Shared Savings Program

    By: Michael Anne Kyle, J. Michael McWilliams, Mary Beth Landrum, Bruce E. Landon, Paul Trompke, David J. Nyweide and Michael E. Chernew
More from the Authors
  • A Mixed Methods Study of Change Processes Enabling Effective Transition to Team-based Care By: Michael Anne Kyle, Emma-Louise Aveling and Sara J. Singer
  • Establishing High Performing Teams: Lessons from Health Care By: Michael Anne Kyle, Emma-Louise Aveling and Sara J. Singer
  • Spending Variation Among ACOs in the Medicare Shared Savings Program By: Michael Anne Kyle, J. Michael McWilliams, Mary Beth Landrum, Bruce E. Landon, Paul Trompke, David J. Nyweide and Michael E. Chernew
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