RESUMO
BACKGROUND: Digital platforms that allow patients to go online or use smartphone applications to view and schedule physician appointments have not been well evaluated. METHODS: We conducted systematic searches for primary care physician appointments in 20 cities using ZocDoc, an online appointment scheduling platform. Availability was determined for three insurance types (self-pay, Medicare, and Medicaid) in states with and without Medicaid expansion. We collected data on physician characteristics, number of appointments available, and distance to clinics. RESULTS: The sample comprised 4150 physician observations across 17 states. Overall, the mean distance to clinic was 8.9 miles (SD: 8.4 miles), mean total number of appointments available within 3 days for the 10 closest physicians was 20.1 (SD: 27.1), and the mean number of physicians available within 5 miles was 5.4 (SD: 6.6). There were no differences in physician characteristics by insurance type. Access to appointments did not differ between Medicare and self-pay. However, compared to self-pay, appointments for Medicaid were further away (Mean difference in miles: 5.4, P < 0.001), and there were fewer physicians available within 5 miles (Mean difference in # of physicians: -4.9, P < 0.001). States that did not adopt Medicaid expansion had fewer appointments within proximity, but this differed similarly across insurance types. CONCLUSIONS: There were a substantial number of available appointments at close distances. However, Medicaid patients had less access to appointments within proximity than self-pay or Medicare patients.
