Effect of open access scheduling on missed appointments, immunizations, and continuity of care for infant well-child care visits

Arch Pediatr Adolesc Med. 2006 Sep;160(9):889-93. doi: 10.1001/archpedi.160.9.889.


Objective: To examine the effect of open access scheduling (OA) on infant well-child care (WCC).

Design: Cluster randomization of 2 methods of OA compared with a baseline group (prior to OA).

Setting: Community health center pediatric clinic, August 1, 2003, to January 31, 2004.

Participants: Ten providers (pediatricians and physician assistants) and 878 infants; 2-, 4-, and 6-month WCC visits were scheduled.

Interventions: Two scheduling methods were compared under the OA model: the OA future visit group scheduled their infant's next WCC visit when leaving the visit, and the OA same day group called for a same-day appointment.

Main outcome measures: Missed appointment rates, on-time immunization rates, and continuity of care.

Results: Missed appointment rates decreased from 21% in the baseline group to 14% and 9% in the OA future visit and OA same day groups, respectively (P<.02). For 630 infants older than 5 months at study end, on-time immunization rates were 59% in the baseline group and 74% in both OA groups (P<.006). Of 412 infants with 2 or more WCC visits, 75% in the OA future visit group and 60% in the OA same day group saw the same provider for all visits (P = .001). This difference was due to differences among providers, not to the different scheduling methods.

Conclusion: Open access scheduling decreases missed appointments for infant WCC visits and appears to increase on-time immunizations.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Appointments and Schedules*
  • Chi-Square Distribution
  • Child Health Services / statistics & numerical data*
  • Continuity of Patient Care*
  • Female
  • Humans
  • Immunization / statistics & numerical data*
  • Infant, Newborn
  • Logistic Models
  • Male
  • Statistics, Nonparametric