JMIR Publications

ABSTRACT

Background:

Diabetes is a chronic disease that requires lifelong management and care, affecting ~422 million people worldwide and roughly 37 million in the U.S. Patients newly diagnosed with diabetes must work with health care providers to formulate a management plan, including lifestyle modifications and regular office visits, to improve metabolic control, prevent or delay complications, optimize quality of life, and promote well-being.

Objective:

The purpose of this study was to investigate one component of system-wide access to timely health care for people with diabetes, in New York City, namely length of time for someone with newly diagnosed diabetes to obtain an appointment with three diabetes care specialists, cardiologist, endocrinologists, and ophthalmologist, respectively. There is a paucity of research on this topic.

Methods:

In this descriptive cross-sectional study, the offices of three different kinds of specialists, cardiologists, endocrinologists, and ophthalmologists, were contacted by telephone to determine the number of days required to schedule an appointment for a new patient with diabetes. The sampling frame was all specialists affiliated with any private or public hospital in New York City. The number of days to obtain an appointment with each specialist was documented along with ‘time on hold’ when attempting to schedule an appointment, and presence of online booking capabilities.

Results:

Of the 1,639 unique physicians affiliated with (private and public) hospitals in the three subspecialities, 1032 (cardiologists, endocrinologists, and ophthalmologists) were in active practice and did not require a referral. The mean wait time for scheduling an appointment was 36 days for cardiologists (standard deviation [SD] = 36.4 days, with an interquartile range [IQR] of 12 to 51.5 days; 82 days for endocrinologists (SD = 47, IQR = 56 to 101 days); and 50.4 days for ophthalmologists (SD = 56, IQR = 10 to 72 days). The median wait time was 27 days for cardiologists, 72 days for endocrinologists, and 30 days for ophthalmologists. The mean time on hold while attempting to schedule an appointment with these specialists was 2.6 minutes (SD = 5.5) for cardiologists, 5.4 minutes (SD = 4.3) for endocrinologists, and 3.2 minutes for ophthalmologists (SD = 4.8), respectively. Over 46% of cardiologists enabled patients to schedule an appointment online and over 55% of endocrinologists enabled patients to schedule an appointment online. In contrast, only approximately 25% of ophthalmologists offered online appointment scheduling options.

Conclusions:

The results from this study provide an initial estimate of wait times required for a new patient to see each of the three specialists in New York City. The results indicate considerable variation in wait times both between and within the three specialties examined. Given the paucity of research on wait times for newly diagnosed people with diabetes to obtain an appointment with different specialists, this study provides preliminary estimates that can serve as an initial reference. Additional research is needed to document the extent to which wait times are associated with complications and with demographic, economic and social characteristics of people served by different providers.