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Mary E. O’Connor, MD, MPH; Bethany S. Matthews, MSPH; Dexiang Gao, PhD

Arch Pediatr Adolesc Med. 2006;160:889-893.

Objective  To examine the effect of open access scheduling (OA) on infant well-child care (WCC).

Design  Cluster randomization of 2 methods of OA compared with a baseline group (prior to OA).

Setting  Community health center pediatric clinic, August 1, 2003, to January 31, 2004.

Participants  Ten providers (pediatricians and physician assistants) and 878 infants; 2-, 4-, and 6-month WCC visits were scheduled.

Interventions  Two scheduling methods were compared under the OA model: the OA future visit group scheduled their infant's next WCC visit when leaving the visit, and the OA same day group called for a same-day appointment.

Main Outcome Measures  Missed appointment rates, on-time immunization rates, and continuity of care.

Results  Missed appointment rates decreased from 21% in the baseline group to 14% and 9% in the OA future visit and OA same day groups, respectively (P<.02). For 630 infants older than 5 months at study end, on-time immunization rates were 59% in the baseline group and 74% in both OA groups (P<.006). Of 412 infants with 2 or more WCC visits, 75% in the OA future visit group and 60% in the OA same day group saw the same provider for all visits (P = .001). This difference was due to differences among providers, not to the different scheduling methods.

Conclusion  Open access scheduling decreases missed appointments for infant WCC visits and appears to increase on-time immunizations.

Author Affiliations: Denver Health (Dr O’Connor and Ms Matthews), Departments of Pediatrics (Dr O’Connor) and Family Medicine (Ms Matthews), University of Colorado School of Medicine, and The Research Institute, The Children's Hospital (Dr Gao), Denver.

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