Reducing Wait Time Improves Treatment Access: Retention

2007 ◽  
Keyword(s):  
Wait Time ◽  
Treatment Access

Patient characteristics predicting attendance for elective in-patient treatment of substance use disorder

2021 ◽  
pp. 103985622110250
Author(s):  
Bridin Murnion ◽  
Anupreet Dhaliwal ◽  
Julian Alsop
Keyword(s):  
Wait Time ◽  
Patient Characteristics ◽  
Patient Treatment ◽  
Treatment Access ◽  
Patient Withdrawal ◽  
Younger Age ◽  
Amphetamine Use ◽  
Alcohol And Other Drugs ◽  
Withdrawal Management ◽  
Significant Health

Objective: Consumption of alcohol and other drugs constitutes a significant health burden. Treatment access is poor, and a number of barriers are recognised. The objective of this retrospective cohort study is to examine patient characteristics of those attending/not attending for elective in-patient withdrawal management (IWM). Methods: Records of all elective admissions for IWM between 1 March and 30 June 2019 were reviewed. Data were extracted on attendance, age, substance(s) used, pre-arranged rehabilitation admissions following discharge, wait time, legal issues and child welfare agency involvement. Results: Of 274 planned admissions, 193 (70%) attended. Attendance was predicted by residential treatment planned after withdrawal management and older age. People using amphetamines were less likely to attend. Conclusion: There are low attendance rates for elective IWM. Patient characteristics predicting lower attendance include younger age, amphetamine use and not planning rehabilitation. Further research is required to improve attendance.

Teacher-student interaction and management practices in Pakistani English language classrooms

2019 ◽  
Vol 7 (3) ◽  
pp. 115-134
Author(s):  
Muhammad Ahmad ◽  
Aleem Shakir ◽  
Ali Raza Siddique
Keyword(s):  
Classroom Management ◽  
English Language ◽  
Management Practices ◽  
Wait Time ◽  
Student Interaction ◽  
Teacher Talk ◽  
Teacher Student ◽  
Language Classroom ◽  
Teacher Student Interaction ◽  
Language Classrooms

Abstract This study aimed to investigate the amount and type of teacher-talk, frequently asked questions and feedback provided by the teacher on learners’ performance in a language classroom. For this purpose, a lecture was recorded from a secondary level English language classroom of a public sector school and interpreted in the light of teacher-student interaction and classroom management model by David Nunan. Results revealed that the maximum amount of time (i.e. 80.1%) was consumed by the teacher which was appropriate. However, certain deviations from classroom management principles were also observed regarding frequently asked questions (i.e. 50% of the total questions were elicitation questions) and the feedback (it was ‘romantic’ in nature). Moreover, wait-time was sufficient but it was of no use to the learners. The study concluded that classroom practices did not conform to the principles therefore, it proposed to ask questions and provide feedback appropriately.

Sociodemographic inequalities in lifetime treatment seeking and receipt for common mental health problems

2020 ◽  
Author(s):  
Christopher Rayner ◽  
Jonathan Richard Iain Coleman ◽  
Kirstin Lee Purves ◽  
Ewan Carr ◽  
Rosa Cheesman ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Mental Health Problems ◽  
Sociodemographic Factors ◽  
Treatment Seeking ◽  
Binary Outcomes ◽  
Treatment Access ◽  
Sociodemographic Correlates ◽  
Common Mental Health Problems ◽  
Poor Outcomes ◽  
Lifetime Treatment

Background: Anxiety and depressive disorders can be chronic and disabling, and are associated with poor outcomes. Whilst there are effective treatments, access to these is variable and only a fraction of those in need receive treatment. Aims: The primary aim was to investigate sociodemographic correlates of lifetime treatment access and unpick the relationships between socioeconomic features and treatment inequalities. As such, we aimed to identify groups at greatest risk of never accessing treatment and targets for intervention. Methods: We tested for sociodemographic factors associated with treatment access in UK Biobank participants with lifetime generalised anxiety or major depressive disorder, performing multivariable logistic regressions on two binary outcomes: treatment-seeking (n=33,704) and treatment receipt (n=28,940). Results: Treatment access was less likely in those who were male, from a UK ethnic minority background and who self-medicated with alcohol or drugs. Treatment access was more likely in those who reported use of self-help strategies, with lower income (<£30,000) and greater neighbourhood deprivation, as well as those with a university degree. Conclusion: This work on lifetime treatment seeking and receipt replicates known correlates of treatment receipt during time of treatment need. Our focus on treatment-seeking and receipt highlights two targets for improving treatment access. More work is required to understand the psychosocial barriers to treatment, which mediate the associations observed here.

Evaluating Virtual Care Experiences for Patients with Covid-19 Chief Complaints: Best-Practices Recommendations (Preprint)

2020 ◽  
Author(s):  
Saif Khairat ◽  
Malvika Pillai ◽  
Barbara Edson ◽  
Robert Gianforcaro
Keyword(s):  
Patient Experience ◽  
Wait Time ◽  
Secondary Outcome ◽  
Major Drawback ◽  
Cross Sectional ◽  
Average Wait Time ◽  
Adherence To Medication ◽  
Virtual Care ◽  
Chief Complaints ◽  
Virtual Visits

BACKGROUND Importance: Positive patient experiences are associated with illness recovery and adherence to medication. The shift toward virtual visits creates a need to understand the opportunities and challenges in providing a patient experience that is at least as positive as in-person visits. OBJECTIVE To evaluate the virtual care experience for patients with Covid-19 as their chief complaints. METHODS We conducted a cross-sectional study of the first cohort of patients with Covid-19 concerns in a virtual clinic. We collected data on all virtual visits between March 20-29, 2020. Outcomes: The main endpoints of this study were patient diagnosis, prescriptions received, referrals, wait time and duration, and satisfaction. The secondary outcome was the reported choice of alternative care options. RESULTS Of the 358 total virtual visits, 42 patients marked “Covid-19 Concern” as their chief complaint. Of those patients, 23 (54.8%) female patients, the average age of patients was 33.9 years, and 41 (97.7%) patients were seeking care for themselves and one (3.3%) visit was for a dependent. For all virtual visits, the average wait time (SD) was 157.2 (181.7) minutes and the average wait time (SD) for Covid-19 Concern visits was 177.4 (186.5) minutes. Covid-19 Concern phone visits had an average wait time (SD) of 180.1 (187.2), compared to 63.4 (34.4) minutes for Covid-19 Concern video visits. Thirteen (65%) patients rated their provider as “Excellent” with similar proportions among phone (64.3%) and video (66.7%). CONCLUSIONS This study evaluated the virtual experiences of patients with Covid-19 concerns. There were different experiences for patients depending on their choice of communication. Long wait times were a major drawback in the patient experience. We have learned from evaluating the experience of our first cohort of Covid-19 Concern patients.

Treatment barriers, preferences and histories of individuals with symptoms of body dysmorphic disorder

2020 ◽  
pp. 1-14
Author(s):  
Jessica McCausland ◽  
Josephine Paparo ◽  
Bethany M. Wootton
Keyword(s):  
Mental Health ◽  
Best Practice ◽  
Body Dysmorphic Disorder ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Cross Sectional Study ◽  
Treatment Barriers ◽  
Treatment Access ◽  
Cross Sectional ◽  
Treatment Delivery

Abstract Background: Individuals with mental health concerns face many barriers when accessing psychological treatment. Even when patients overcome these barriers, they often do not receive an evidence-based treatment. Although the current literature highlights these issues clearly across psychological disorders, the research is limited in relation to body dysmorphic disorder (BDD). Aim: The aim of this study was to examine psychological treatment barriers, treatment delivery preferences and treatment histories of individuals with symptoms of BDD. Method: A total of 122 participants with clinically significant BDD symptoms (94% female; mean age = 34.19 years, SD = 10.86) completed the cross-sectional study. Results: The most frequently reported barriers to accessing psychological treatment for individuals with BDD symptoms were the cost of treatment (41%) and the belief that the symptoms did not warrant treatment (36%). Although 69% of treatment-seeking participants reported previously receiving cognitive behavioural therapy (CBT) for BDD, only 13% of participants appeared to receive best-practice CBT. The preferred modality of future psychological treatment delivery was face-to-face treatment with a therapist once a week (63%), rather than accelerated or remote treatment approaches. Conclusions: The study suggests that there are significant barriers to accessing CBT for BDD. Reducing these barriers, as well as increasing consumer mental health literacy, is required to improve treatment access and treatment outcomes for individuals with BDD.

scholarly journals Behind the clock: elucidating factors contributing to longer clinic appointment duration and patient wait time

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Jonathan Kagedan ◽  
Stephen B. Edge ◽  
Kazuaki Takabe
Keyword(s):  
Wait Time ◽  
High Volume ◽  
Advanced Practice ◽  
Single Institution ◽  
Clinic Appointment ◽  
Nurse Assessment ◽  
Patient Wait Time ◽  
Encounter Time ◽  
Examination Room

Abstract Background Longer wait time in ambulatory clinics can disrupt schedules and decrease satisfaction. We investigated factors associated with patient wait time (WT, check-in to examination room placement), approximate clinician time (ACT, completion of nurse assessment to check-out), and total appointment length (TAL, check-in to check-out). Methods A single-institution retrospective study was conducted of breast surgery clinic patients, 2017–2019, using actual encounter times. A before/after analysis compared a five-day 8 hour/day (from a four-day 10 hour/day) advanced practice provider (APP) work-week. Non-parametric tests were used, and medians with interquartile ranges (IQRs) reported. Results 15,265 encounters were identified. Overall WT was 15.0 minutes (IQR:6.0–32.0), ACT 49.0 minutes (IQR:31.0–79.0) and TAL 84.0 minutes (IQR:57.0-124.0). Trainees were associated with 30.0 minutes longer ACT (p < 0.0001); this increased time was greatest for follow-up appointments, least for new patients. Patients arriving > 5 minutes late (versus on-time) experienced shorter WT (11.0 vs. 15.0 minutes, p < 0.0001) and ACT (43.0 vs. 53.0 minutes, p < 0.0001). Busier days (higher encounter volume:APP ratios) demonstrated increased encounter times. After transitioning to a five-day APP work-week, ACT decreased. Conclusions High-volume clinics and trainee involvement prolong ambulatory encounters. Increasing APP assistance, altering work schedules, and assigning follow-up appointments to non-trainees may decrease encounter time.

scholarly journals 662 PAP Therapy: A Review of Resources for the Uninsured during COVID-19

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A259-A259
Author(s):  
Melissa Malinky ◽  
Abigail Oberla ◽  
Meena Khan ◽  
M Melanie Lyons
Keyword(s):  
Low Income ◽  
Web Search ◽  
Low Cost ◽  
Wait Time ◽  
The United States ◽  
Fixed Cost ◽  
United States Census ◽  
Lower Socioeconomic ◽  
Increased Risk ◽  
Available Resources

Abstract Introduction In 2019, the United States Census estimated 8% (26.1 million) people were without health insurance. Further, an estimated 3.5 million people became/remained uninsured from COVID-19-related job losses. Patients with OSA that belong to a lower socioeconomic status (SES) are less likely to have access to healthcare and may be under or uninsured. Untreated OSA can lead to increased risk of symptoms and associated co-morbidities. Resources to help the uninsured to obtain PAP therapy were available pre-COVID, including two main sources, American Sleep Apnea Association (ASAA) and our local branch serving central Ohio, The Breathing Association. However, the COVID pandemic limited access or closed these programs. Our Sleep Medicine clinics saw 148 uninsured OSA patients between March-December, 2020. Given these difficulties, we re-evaluated available resources for the uninsured. Methods We conducted a search for current low cost ($100 or less) PAP therapy options for the uninsured, March 15, 2020-December 3, 2020, by: (1) contacting pre-COVID-19 resources, including Durable Medical Equipment (DME) providers, (2) consulting social work, and (3) completing a librarian assisted web-search not limited to PubMed, Embase, CINAHL for academic related articles and electronic searches using a combination of English complete word and common keywords: OSA, PAP, uninsured, no insurance, cheap, medically uninsured, resources, self-pay, low-income, financial assistance, US. Resources such as private sellers were not investigated. Results During COVID-19, assistance for PAP machines/supplies have closed or required a protracted wait-time. Options including refurbished items range from low, one-time fixed cost or income-based discounts from: one local charity (Joint Organization for Inner-City Needs) and DME (Dasco), and four national entities (ASAA, Second Wind CPAP, Reggie White Foundation, CPAP Liquidators). An Electronic Health Record-based tool was developed and distributed to increase provider awareness of pandemic available resources. Conclusion Untreated OSA is associated with increased risk of cardiovascular co-morbidities. Access and cost may limit treatment in OSA patients from a lower SES. The COVID-19 pandemic has shuttered programs providing discount PAP and supplies, leaving fewer resources for these patients, thus further widening this health care disparity. Alternatives are needed and current resources are not easily accessible for providers and patients. Support (if any):

Sign in / Sign up

Export Citation Format

Share Document