BACKGROUND Access to dermatologists is low among Medicaid-insured patients. Higher clinic nonattendance among Medicaid-insured patients might affect provider decisions to accept these patients. OBJECTIVE To determine the effect of different scheduling policies on the attendance among children seen at a pediatric dermatology clinic. METHODS In this retrospective review, we compared nonattendance among children for 3 different scheduling policies implemented over 3 consecutive years. The scheduling policies used were a first-available open scheduling policy, a 2-week in advance scheduling policy, and a 4-week in advance scheduling policy. Subset analyses were performed by clinic location and insurance type. RESULTS The interval between scheduling and appointment date was directly related to nonattendance rates; rates were higher for Medicaid-insured than privately insured patients. Open scheduling was associated with a 37% nonattendance rate for Medicaid-insured patients and 18% nonattendance rate for privately insured patients. A 4-week in advance scheduling policy significantly decreased the nonattendance rate to 19% among Medicaid-insured and 7% among privately insured patients. A 2-week in advance policy further decreased the nonattendance rate to 11% among Medicaid-insured patients and 4% among privately insured patients. LIMITATIONS This is a retrospective study, and same-day cancellations were not tracked. CONCLUSION Decreasing the time interval between scheduling and appointment dates can significantly decrease nonattendance. This strategy might help dermatologists incorporate more Medicaid-insured patients into their practices.

中文翻译：

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提高有医疗补助或私人保险的小儿患者的就诊率。

背景技术在有医疗补助的患者中，皮肤科医生的访问率很低。医疗补助患者中较高的门诊缺勤率可能会影响提供者决定接受这些患者的决定。目的确定在儿科皮肤病诊所看待的不同日程安排政策对儿童出勤的影响。方法在这项回顾性审查中，我们比较了连续3年实施的3种不同的调度策略的孩子之间的缺勤情况。使用的调度策略是第一个可用的开放式调度策略，提前2周的调度策略和提前4周的调度策略。根据诊所位置和保险类型进行子集分析。结果安排与约会日期之间的时间间隔与缺勤率直接相关。医疗补助保险的比率高于私人保险的病人。开放式安排与医疗补助保险患者的37％无人值守率和私人保险患者18％的无人值守率相关。提前4周的计划政策将医疗补助参保人员的缺勤率显着降低至19％，而私人参保患者的缺勤率则降至7％。提前两周的政策进一步将医疗补助保险患者的缺勤率降低到11％，私人保险患者的缺勤率降低到4％。限制这是一项回顾性研究，未跟踪当天取消的情况。结论缩短安排时间和约会日期之间的时间间隔可以显着减少缺勤的情况。这种策略可能有助于皮肤科医生将更多由医疗补助保险的患者纳入他们的实践中。