Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States

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Auteurs principaux: Michaele Francesco Corbisiero, Tyler M. Muffly, Drew C. Gottman, Madeline Olson, Yasmine Hachicha, Elizabeth Garcia‐Creighton, Natalie Gallego, Maryam Elsayed, Sophia Ahmed, Cristina Cabrera‐Muffly
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author Michaele Francesco Corbisiero
Tyler M. Muffly
Drew C. Gottman
Madeline Olson
Yasmine Hachicha
Elizabeth Garcia‐Creighton
Natalie Gallego
Maryam Elsayed
Sophia Ahmed
Cristina Cabrera‐Muffly
author_facet Michaele Francesco Corbisiero
Tyler M. Muffly
Drew C. Gottman
Madeline Olson
Yasmine Hachicha
Elizabeth Garcia‐Creighton
Natalie Gallego
Maryam Elsayed
Sophia Ahmed
Cristina Cabrera‐Muffly
Michaele Francesco Corbisiero
Tyler M. Muffly
Drew C. Gottman
Madeline Olson
Yasmine Hachicha
Elizabeth Garcia‐Creighton
Natalie Gallego
Maryam Elsayed
Sophia Ahmed
Cristina Cabrera‐Muffly
collection Wiley Open Access
contents Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States Michaele Francesco Corbisiero Tyler M. Muffly Drew C. Gottman Madeline Olson Yasmine Hachicha Elizabeth Garcia‐Creighton Natalie Gallego Maryam Elsayed Sophia Ahmed Cristina Cabrera‐Muffly Otolaryngology–Head and Neck Surgery AbstractObjectiveTo investigate potential differences in new patient appointment wait times for otolaryngology care based on insurance types and explore factors influencing these wait times.Study DesignA cross‐sectional audit study, using a “mystery caller” approach, analyzed with a linear mixed Poisson model to adjust for confounding factors.SettingA total of 612 physicians across 49 states and the District of Columbia, representing 6 otolaryngology subspecialties, were included.MethodsOtolaryngology physicians were contacted by mystery callers via telephone with scripted clinical vignettes as patients with either Medicaid or Blue Cross/Blue Shield (BCBS) insurance. Callers requested next available appointment. Wait times for new patient appointments were recorded and analyzed in R using a generalized linear mixed Poisson model.ResultsA total of 1183 of 1224 calls reached a representative. Medicaid patients waited 5.73% longer (P < .001) compared to BCBS patients (IRR: 1.06; confidence interval [CI]: 1.03‐1.09; P < .001), with respective mean wait times of 36.8 days (SE ± 1.6) and 32.4 days (SE ± 1.6). Longer waiting times were also associated with physicians affiliated with universities (P = .001) and certain subspecialties, such as pediatric otolaryngology (P < .001) and neurotology (P = .008). Regional differences were also observed, with specific AAO‐HNS regions showing shorter wait times. The model achieved a conditional R‐squared value of 0.947.ConclusionThis study reveals disparities in wait times for otolaryngology care based on insurance type, with extended wait times for Medicaid beneficiaries. The findings highlight a potential access to care disparity, which begets the need for strategies that ensure equitable access to otolaryngology care and further research to understand the underlying reasons for these potential disparities. 10.1002/ohn.752 http://onlinelibrary.wiley.com/termsAndConditions#vor
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spellingShingle Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States
Michaele Francesco Corbisiero
Tyler M. Muffly
Drew C. Gottman
Madeline Olson
Yasmine Hachicha
Elizabeth Garcia‐Creighton
Natalie Gallego
Maryam Elsayed
Sophia Ahmed
Cristina Cabrera‐Muffly
Otolaryngology–Head and Neck Surgery
Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States Michaele Francesco Corbisiero Tyler M. Muffly Drew C. Gottman Madeline Olson Yasmine Hachicha Elizabeth Garcia‐Creighton Natalie Gallego Maryam Elsayed Sophia Ahmed Cristina Cabrera‐Muffly Otolaryngology–Head and Neck Surgery AbstractObjectiveTo investigate potential differences in new patient appointment wait times for otolaryngology care based on insurance types and explore factors influencing these wait times.Study DesignA cross‐sectional audit study, using a “mystery caller” approach, analyzed with a linear mixed Poisson model to adjust for confounding factors.SettingA total of 612 physicians across 49 states and the District of Columbia, representing 6 otolaryngology subspecialties, were included.MethodsOtolaryngology physicians were contacted by mystery callers via telephone with scripted clinical vignettes as patients with either Medicaid or Blue Cross/Blue Shield (BCBS) insurance. Callers requested next available appointment. Wait times for new patient appointments were recorded and analyzed in R using a generalized linear mixed Poisson model.ResultsA total of 1183 of 1224 calls reached a representative. Medicaid patients waited 5.73% longer (P < .001) compared to BCBS patients (IRR: 1.06; confidence interval [CI]: 1.03‐1.09; P < .001), with respective mean wait times of 36.8 days (SE ± 1.6) and 32.4 days (SE ± 1.6). Longer waiting times were also associated with physicians affiliated with universities (P = .001) and certain subspecialties, such as pediatric otolaryngology (P < .001) and neurotology (P = .008). Regional differences were also observed, with specific AAO‐HNS regions showing shorter wait times. The model achieved a conditional R‐squared value of 0.947.ConclusionThis study reveals disparities in wait times for otolaryngology care based on insurance type, with extended wait times for Medicaid beneficiaries. The findings highlight a potential access to care disparity, which begets the need for strategies that ensure equitable access to otolaryngology care and further research to understand the underlying reasons for these potential disparities. 10.1002/ohn.752 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States
topic Otolaryngology–Head and Neck Surgery
url https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.752