Background: The possibility of seeing a clinician on the same day or following day is limited and declining in high-income countries, directly contributing to overcrowding of emergency departments for nonurgent medical issues. This systematic review examined 29 studies on advanced access, a scheduling model that involves keeping a substantial proportion of appointment slots open each day to accommodate same-day demand.
What They Found: Using Advanced access in primary care caused wait times to fall in all 23 studies that measured them, though only 13 provided statistical confirmation. Among the 13 studies assessing continuity of care, 11 reported improvements after implementation of advanced access. Of these, 7 studies demonstrated statistically significant improvements. In contrast, two studies observed declines in continuity of care after implementation of advanced access, one of which reached statistical significance. All three studies that measured emergency department use reported fewer visits, though none reached statistical significance. Patient satisfaction improved in 8 studies, with 3 reporting statistically significant improvements.
Implications: The authors describe advanced access as a potentially promising approach for improving how primary care appointments are scheduled.
Association of Advanced Access With Primary Care Performance: A Systematic Review
Corresponding author: Simon Berthelot, MD, MSc, et al
Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada
Département de médecine de famille et de médecine d'urgence, Université Laval, Québec City, Québec, Canada
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