Effect of a same day appointment initiative on racial disparities in access for radiation oncology

J Cancer Policy. 2023 Dec:38:100445. doi: 10.1016/j.jcpo.2023.100445. Epub 2023 Sep 15.

Abstract

Purpose: We present our single-institution experience with the development of a same day access scheduling initiative for an outpatient radiation oncology unit, focusing on its potential influence on ameliorating racial disparities.

Methods and materials: From March 2021 to August 2022, a pilot initiative was conducted such that all new patients referred to a tertiary care-based radiation oncology department were offered the ability to be seen as a same day consultation. The timespan of this analysis was categorized into 2 distinct successive periods over 36 months-a 18-month pre-initiative period (September 2019 to February 2021) and another subsequent one (March 2021 to August 2022). Descriptive statistics were used to study the impact of this initiative on access-related benchmarks.

Results: A total of 2897 patients were referred. Among the 2107 patients scheduled, three hundred and sixteen (15 %) opted for same day appointments. Black, Latino, and Asian patients were significantly more likely to use the same day access initiative versus Caucasian patients (p = 0.01). The same day access initiative increased the proportion of patients seen within 5 days from referral from 8 % to 34 % for Blacks, 12-57 % for Latinos, and 18-67 % for Asians, compared to 39-55 % for Caucasians (p < 0.001). The no-show rate was reduced from 20 % to 7 % and 14-5 %, for Black and Latino patients, respectively (p < 0.001).

Conclusions: The implementation of a same day access initiative narrowed disparities with respect to access-related benchmarks.

Keywords: Access; Appointments; Racial disparities; Radiation oncology; Same day.

MeSH terms

  • Appointments and Schedules*
  • Asian
  • Black People
  • Healthcare Disparities* / ethnology
  • Hispanic or Latino
  • Humans
  • Racial Groups
  • Radiation Oncology*
  • White People