Barriers to primary health care may include time barriers to obtain appointments or spent in waiting rooms, travel time or distance to the practice, transportation barriers, non-availability of evening-night or weekend appointments and non-availability of primary care physicians and other health care professionals in the area.
Reducing missed appointments could increase efficiency and availability of gastroenterology care, minimize the financial losses associated with no-show, and has the potential to improve patient outcomes.
One patient described community acupuncture treatment as "…so accessible in terms of price and availability of appointments".
Each comprised separate patients and physicians originally assigned based on space and appointment availability, housed in the same building, but with separate waiting areas and nursing and clerical staff.
Endorsement of transport and appointment availability concerns was the same for men and women, but men were more likely to say that they would be too busy to make time to see the doctor (P=0.02) (although in the African group, women were more likely to endorse this barrier).
Interestingly, in these studies some secondary care staff and patients felt that GPs would not be able to deliver the same quality of care because of their limited experience and availability of appointment times [ 17, 18].
Expanding secondary care services in proportion to increasing demand is not the ideal solution, as increasing the capacity and availability of hospital appointments, although tending to increase costs, does not automatically lead to improved access for all patient groups.
Thirdly Baker describes the use of a validated surgery satisfaction questionnaire (SSQ) that he developed [ 27, 28] and finally Grogan's patient Satisfaction Questionnaire contains two sections that ask about access and appointment availability[ 29].
Unpublished quality improvement work undertaken at the study site has shown that billings and appointment availability went up post-EMR, despite the clinic being mostly closed to new patients, with the exception of prenatal and pediatric patients.
Patient access to the practice improved with increased availability of appointments and practice staff experienced improved workplace relationships and satisfaction.
