Background Advanced (“open”) access scheduling, which promotes patient-driven scheduling in lieu of pre-arranged appointments, has been proposed as a more patient-centered appointment method and has been widely adopted within the United Kingdom and Veterans Health Administration and among U.S. private practices. Objective To describe patient, physician and practice outcomes resulting from implementation of advanced access scheduling in the primary care setting. Data Sources Comprehensive search of electronic databases (MEDLINE, Scopus, Web of Science) until August 2010, supplemented by reviewing reference lists and gray literature. Study Selection Studies were assessed blinded and in duplicate. Controlled and uncontrolled English-language studies of advanced access implementation in primary care were eligible if they specified methods and reported outcomes data. Data Extraction 2 reviewers collaboratively assessed risk for bias by using the Cochrane Effective Practice and Organisation of Care Group Risk of Bias criteria. Data were independently extracted in duplicate. Data Synthesis 28 papers describing 24 studies met eligibility criteria. All studies had at least one source of potential bias. All 8 studies evaluating time to third next available appointment showed reductions (range of decrease 1.1–32 days) but only 25% (2/8) achieved a third-next-available appointment <48 hours. No-show rates improved only in practices with baseline no-show rates >15%. Effects on patient satisfaction were variable. Limited data addressed clinical outcomes and loss to follow-up. Conclusion Studies of advanced access support benefits to wait time and no-show rate. However, effects on patient satisfaction were mixed and data about clinical outcomes and loss to follow-up were lacking.

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