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For Diabetics, On-Demand Care May Not Help
Date:3/31/2009

Blood pressure control was worse with newer scheduling option, study finds

TUESDAY, March 31 (HealthDay News) -- Diabetic adults using same-day medical scheduling to manage their care fared no better and, in some aspects, saw their condition worsen, compared with those who made their doctor's appointments in advance as usual, a new study finds.

With on-demand, or open-access, scheduling, doctors' offices give patients a general time period when they should come in for a follow-up, and the patients can then book their appointment on the day they want it or the day before. Some studies have linked open-access scheduling to more satisfied patients.

But the new study, by researchers at the Indiana University School of Medicine, found that such a system does not appear to benefit people with a chronic disease such as diabetes. It involved 4,060 adult diabetics and 12 clinics, half using open-access scheduling and half following usual in-advance scheduling of appointments.

"We were surprised and concerned to find that, with open-access scheduling, patients did less well with their blood pressure," the study's first author, Dr. Usha Subramanian, an assistant professor of medicine, said in a news release issued by the university. "Control of blood pressure is probably the single most important medical intervention to improve survival and reduce health-care costs for those with diabetes."

The study reported that the rate of hospitalization or visits to hospital emergency departments were the same for people who visited clinics using open-access scheduling and those who went to places with traditional scheduling practices.

"It appears that timely follow-up for chronic disease management may be compromised if patients are required to remember and schedule their appointment at a suggested interval as opposed to putting a previously scheduled appointment on the calendar and remembering to get to the doc
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