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October 13, 2015

Health Care Scheduling and Access: A Report From the IOM

Author Affiliations
  • 1Virginia Mason Health System, Seattle, Washington
JAMA. 2015;314(14):1449-1450. doi:10.1001/jama.2015.9431

The Institute of Medicine report Crossing the Quality Chasm identified timeliness as one of the fundamental aims of health care. Timeliness is increasingly recognized as an important factor in quality of care, and measuring wait times, or the amount of time it takes for a patient to have access to an appointment and see a clinician, has emerged as a key indicator of overall system performance.

At the extreme, extended wait times and delays for care negatively affect morbidity, mortality, and quality of life1-3 as well as health care utilization and patient experience. National attention on the topic of timeliness reached a new level in 2014 with the discovery that 1700 veterans in need of primary care appointments in the Veterans Affairs (VA) Phoenix Health Care system had been left off the mandatory electronic waiting list, and 40 veterans died while waiting for an appointment.4 Although there is not enough evidence to conclude that the prolonged waits were the cause of these deaths, the VA investigation documented poor quality of care.