title: Effect of open access scheduling on missed appointments, immunizations, and continuity of care for infant well-child care visits.
abstract: OBJECTIVE
  To examine the effect of open access scheduling (OA) on infant well-child care (WCC).
  
  
  METHODS
  Cluster randomization of 2 methods of OA compared with a baseline group (prior to OA).
  
  
  METHODS
  Community health center pediatric clinic, August 1, 2003, to January 31, 2004.
  
  
  METHODS
  Ten providers (pediatricians and physician assistants) and 878 infants; 2-, 4-, and 6-month WCC visits were scheduled.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Open access scheduling decreases missed appointments for infant WCC visits and appears to increase on-time immunizations.
authors.affiliation: Denver Health, Departments of Pediatrics and Family Medicine, University of Colorado School of Medicine, and The Research Institute, The Children's Hospital, Denver, USA. mary.o'connor@dhha.org
authors.forename: Mary E
authors.initials: ME
authors.lastname: O'Connor
authors.forename: Bethany S
authors.initials: BS
authors.lastname: Matthews
authors.forename: Dexiang
authors.initials: D
authors.lastname: Gao
mesh_terms: D001071:Appointments and Schedules; D016009:Chi-Square Distribution; D002662:Child Health Services / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D018709:Statistics, Nonparametric