Measuring access to primary care appointments: a review of methods

A search and review was made of the primary care literature from 1990 to 2001, which included an assessment of online resources (websites) and communication with recognised experts. The identified methods were assessed.The published literature in this specific area was not extensive but revealed emerging interest in the late 1990s. Two broad approaches to the measurement of waiting times to GP appointments were identified. Firstly, appointment systems in primary care organisations were analysed in differing ways to provide numerical data and, secondly, patient perceptions (reports) of access were evaluated using survey techniques. Six different methods were found which were based on appointment systems data.The two approaches of either using patient questionnaires or appointment system data are methods that represent entirely different aims. The latter method when used to represent patient waiting times for 'routine' elective appointments seems to hold promise as a useful tool and this avoids the definitional problems that surround 'urgent' appointments. The purpose for which the data is being collected needs to be borne in mind and will determine the chosen methods of data retrieval and representation.Primary care is under scrutiny along with other public services to improve access to its users. Access in primary care is typically conceptualised as the achievable access to appointments with clinical professionals, although it is not routinely measured in most practices. It is widely recognised that it represents an important dimension in determining the quality of care [1,2]. Nevertheless, it is also known that waiting times can vary widely in differing localities and countries, from patients being seen the same day to a wait of several weeks. Most primary care organisations have no more than a perception of variable demand and no method of comparing fluctuating levels of access to appointments within or between practices. Measuring patient access could generate us