Greater time burden for medical care among minorities, unemployed

Time spent at a health care provider’s office, along with travel time to and from the office, was 25% to 28% longer among minority and unemployed patients, according to recently published data.

The researchers analyzed data from the 2005–2013 American Time Use Survey and the 2006-2010 National Ambulatory Medical Care Survey to assess the correlation between socioeconomic variables and visit characteristics with time associated with obtaining medical care.

Results demonstrated that on average, patients spent 123 minutes obtaining medical care. This included 86 minutes of clinic time, which includes face-to-face time with a physician, and 38 minutes of travel time.

A significant association was found between longer clinic time and patients of ethnic or racial minority, those with less education and those who were unemployed. Compared with non-Hispanic white patients who had 80 minutes of clinic time, Hispanic patients had 105 minutes of clinic time (P < .001), according to the results.

Total travel time was significantly longer for minority and unemployed participants.

Overall, face-to-face time with a physician was 20.5 minutes on average. No significant association was seen between face-to-face time and patient characteristics.

The researchers noted that longer clinic time among minority and unemployed patients, but not longer time with a physician, may indicate that more time is spent completing paperwork, paying bills, interacting with other office staff or waiting.

“For individuals, excess time burden may create a disincentive to seeking care. Given that racial/ethnic minorities and unemployed persons disproportionally receive care at community health centers, the differences in clinic time may reflect the struggles of these centers to manage clinical appointments efficiently, as well as the consequences of obtaining care in walk-in clinics or emergency departments where appointments are not scheduled,” the researchers concluded.

In an accompanying editorial, Joseph S. Ross, MD, MHS, associate editor of JAMA Internal Medicine and Mitchell H. Katz MD, deputy editor of JAMA Internal Medicine, noted that patient waiting times is a well-known issue, but little research is done to address it.

“This study characterizes a problem we all know to exist. We need additional work to assure the timeliness and equitability of care through effective interventions to shorten the time spent waiting,” Ross and Katz concluded. – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.

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