title: How Long Do Adolescents Wait for Psychiatry Appointments?
abstract: Appointment wait times are a neglected dimension of children's access to psychiatry. We systematically examined how long an adolescent waits for a new patient appointment with a psychiatrist for routine medication management. From state directories, we identified 578 providers of adolescent psychiatric care in Ohio. Researchers posing as parents telephoned randomly selected offices, seeking care for a hypothetical 14-year-old patient under different scenarios. Overall, we measured 498 wait times at 140 unique offices. The median wait time was 50 days (interquartile range = 29-81 days). In adjusted models, adolescents with Medicaid waited longer than those with private insurance, especially during the spring (geometric mean = 50.9 vs. 41.9 days; p = 0.02). Wait times also varied markedly by region, with geometric means ranging from 22.4 to 75.1 days (p < 0.01). This study demonstrates that adolescents often experience lengthy wait times for routine care. This methodology represents a useful approach to real-time monitoring of psychiatric services.
authors.affiliation: Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 359-A Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA. kjsteinman@gmail.com.
authors.forename: Kenneth J
authors.identifier: http://orcid.org/0000-0002-9290-5426
authors.initials: KJ
authors.lastname: Steinman
authors.affiliation: Division of Biostatistics, The Ohio State University College of Public Health, 249 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA.
authors.forename: Abigail B
authors.initials: AB
authors.lastname: Shoben
authors.affiliation: Division of Health Services Management and Policy, The Ohio State University College of Public Health, 238 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA.
authors.forename: Allard E
authors.initials: AE
authors.lastname: Dembe
authors.affiliation: Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Kelleher
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000458:organization & administration; D001071:Appointments and Schedules; D002648:Child; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000628:therapy*; D009820:Ohio; D012111:Residence Characteristics; D012424:Rural Population; D013689:Telephone; D014481:United States; D014505:Urban Population; D014850:Waiting Lists
keywords: Adolescent; Appointments and schedules; Health insurance; Medicaid; Mental health services; Patient simulation