Use of Advanced Practice Providers to Improve Patient Access in Urology

Chen, Melody; Kiechle, Jonathan E.; Maher, Zachary; Gonzalez, Christopher

doi:10.1016/j.urpr.2018.07.001

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…Simply adding urologists to the practice may decrease the overall lag time for appointments, although this is not likely to be the sole solution or even possible in the years to come with an aging population and a growing urology physician shortage. 6 Increasing the role and utilization of advanced practice providers may be a means to accomplish decreased wait times as demonstrated by Chen et al 14 This practice may augment available services and reduce wait times for new patients. By diverting less severe issues such as voiding trials to capable staff, urologists are able to consult more quickly on patients with complicated or more serious issues.…”

Section: Discussionmentioning

confidence: 99%

Increased Time between Scheduling Date and Appointment Date Results in Increased No-Show Rates in the Academic Urology Practice

et al. 2020

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Introduction: No-show appointments can weigh heavily on a urology practice's finances and productivity. Our objective was to investigate if a relationship existed between lag time and no-show appointments at the Columbia University Medical Center department of urology. Methods: We queried adult new patient appointments from July 2017 to July 2018 and excluded rescheduled or cancelled visits. We organized appointments by subspecialty training/practice of the urologist (general urology, voiding dysfunction/female urology, male sexual dysfunction/infertility, urological oncology, endourology and reconstructive urology). We performed logistic regression analysis to determine the relationship between lag time and no-show rate. We did the same for age and gender. We also organized lag time into 4 categories (less than 3 days, 3 to 7 days, 8 to 14 days, more than 14 days) and performed a goodness of fit test for no-show rates. Results: A total of 6,060 new patient appointments were scheduled from July 2017 to July 2018. The no-show rate was 14.3% (865 patients). Each daily increase in lag time resulted in a 2% rise in the odds of no-shows for the overall practice (OR 1.02). There were similar results for sexual dysfunction (OR 1.03), general urology (OR 1.02), oncology (OR 1.02) and voiding dysfunction (OR 1.01). There was a positive correlation with increasing lag time category and no-show rates for all subspecialties (R 2 >0.80) except reconstructive urology (R 2 ¼0.68). Each increase in age resulted in a 2% rise in the odds of no-shows (OR 0.98). Conclusions: Lag time for new patient visits is highly correlated with no-show rates, with a 2% rise in the odds of a no-show with each daily increase in lag time. Increasing age also demonstrated a correlation with no-show rates. Practice interventions to reduce lag time will hopefully reduce no-show rates.

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Section: Discussionmentioning

confidence: 99%

Increased Time between Scheduling Date and Appointment Date Results in Increased No-Show Rates in the Academic Urology Practice

et al. 2020

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“…20 Within urology specifically, studies have found that scheduling an initial visit with an APP could reduce wait time by 10-15 days. 21,22 Clarifying the growing role of APPs in men's health conditions can help guide the development of more targeted training, certification, and supervision for APPs in urology. The AUA suggests a current framework for the integration of APPs via a team-based approach of the supervisory/collaborative model.…”

Section: Discussionmentioning

confidence: 99%

Increasing Role of the Advanced Practice Provider in Men’s Health Clinics: An Analysis of Medicare and Commercial Claims in the United States

et al. 2023

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Introduction:As urological care delivery in the U.S. continues to evolve to meet patient needs, we aim to clarify the role of advanced practice providers for publicly and privately insured patients in the treatment of male urological conditions commonly encountered in men’s health clinics.Methods:Medicare and commercial insurance claims from the Physician/Supplier Procedure Summary and Merative MarketScan Commercial Database were queried for procedures submitted by advanced practice providers between 2010 and 2021. Common urological conditions were identified using Current Procedural Terminology codes and grouped into 4 categories: testicular hypofunction, erectile dysfunction and Peyronie’s disease, benign prostatic hyperplasia, and scrotal pain. The proportion of procedures submitted by advanced practice providers was calculated for each year and category.Results:From 2010 to 2021, the proportion of advanced practice provider–submitted service counts for each condition within the MarketScan group increased up to 5-fold, with benign prostatic hyperplasia representing the greatest growth. The proportion of advanced practice provider–submitted service counts within the Medicare group increased up to 8-fold, with erectile dysfunction/Peyronie’s disease representing the greatest fold change. The proportion of claims submitted by advanced practice providers treating all 4 conditions was higher in 2021 than 2010 in both publicly and privately insured groups.Conclusions:The role of advanced practice providers in men’s urological health is increasing for both privately and publicly insured patient populations. Advanced practice providers play a critical role in urological care and can help to improve access to men’s health.

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“…However, the results of improved access to care with the addition of APPs to care teams are consistent with the literature. [6][7][8][10][11][12]…”

Section: Limitationsmentioning

confidence: 99%

“…9 This allows for more patients to be seen and timelier. Research on this particular team composition in specialty areas is limited, but adding APPs to care teams has improved access to care in gastroenterology, 10 neurosurgery, 10 urology, 11 and oncology. 12…”

Section: Introductionmentioning

confidence: 99%

Team-Based Care Model Improves Timely Access to Care and Patient Satisfaction in General Cardiology

Sharpe,

Eastham

2023

J Healthc Qual

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Appointment wait times have increased nationally since 2014, especially in cardiology. At a mid-Atlantic academic medical center, access to care in the general cardiology clinic was below national standards, which can negatively affect patient outcomes and satisfaction. Adopting a team-based care (TBC) model, advanced practice providers (APPs) were added to care teams with general cardiologists to provide timely outpatient management of cardiac conditions. This aimed to increase access to care and, consequently, patient satisfaction. A formative program evaluation using the Agency for Clinical Innovation framework assessed TBC's impact on these outcomes. Access to care and patient satisfaction measures for TBC and nonteam providers were compared with one another and national benchmarks. Nine months after implementation, the average time to new patient appointment for TBC providers was 31 days (47% decrease) and for nonteam providers was 41 days (20% decrease). TBC had a higher percentage of new patient appointments within 14 days than nonteam providers (39% and 20%, respectively). Patient satisfaction improved to the 98th percentile nationally for TBC but decreased to the 71st percentile for nonteam. These findings suggest that a TBC model using APPs can improve access to care and patient satisfaction in the outpatient general cardiology setting.

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Use of Advanced Practice Providers to Improve Patient Access in Urology

Cited by 6 publications

References 8 publications

Increased Time between Scheduling Date and Appointment Date Results in Increased No-Show Rates in the Academic Urology Practice

Increased Time between Scheduling Date and Appointment Date Results in Increased No-Show Rates in the Academic Urology Practice

Increasing Role of the Advanced Practice Provider in Men’s Health Clinics: An Analysis of Medicare and Commercial Claims in the United States

Team-Based Care Model Improves Timely Access to Care and Patient Satisfaction in General Cardiology

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