Improving Clinical Access and Continuity Using Physician Panel Redesign

Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, MA 01003, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 10/2010; 25(10):1109-15. DOI: 10.1007/s11606-010-1417-7
Source: PubMed


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.
Using systems engineering methods, to re-design physician patient panels targeting optimal access and continuity of care.
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).
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).
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.
Redesigning primary care physician panels can improve access to and continuity of care for patients.

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    • "Age and gender is the simplest patient classification in absence of other data, yet is generally effective [Murray et al., , Balasubramanian et al. 2010]. Figure 2 illustrates the distribution of the fraction (or percentage) of total patients requesting appointments in a week for two categories males (48-53 y.o.) and women (73-78 y.o.), based on on historical data "
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