More Office Hours, Lower Expenditures

Physician practices that offer night and weekend hours keep costs down without adversely affecting mortality rates, according to a study in the Annals of Family Medicine.

The study — “Extended Office Hours and Health Care Expenditures: A National Study” — says that “Extended access may thus represent a marker of primary care practices with a cost-conscious approach. This finding may be useful to health administrators and policy makers interested in relatively simple ways of identifying such practices — a seemingly important aim given the health care financing crisis.”

The study ( analyzed nearly 31,000 responses to the Medical Expenditure Panel Surveys (MEPS), finding that patients with access to physicians with extended hours had more than 10 percent lower total expenditures for office visits, ER use, prescription medications, and hospitalizations.

It’s too soon, however, to demand that doctors change their routines, Anthony Jerant, MD, the main author of the study, tells Managed Care. “We think it is premature to recommend, based on this one study, that all physicians consider adding evening and weekend hours.”

Still, the study states that “extended hours may be associated with relatively judicious use of primary health care resources (e.g., more generic medication prescribing, less discretionary testing), with no apparent adverse effects on survival.”

Data were collected from people ages 18–90 who participated in the surveys.

“It’s pooled data for 2000–2008,” says Jerant. “Each individual participant in MEPS is enrolled only for two years.” If a person enrolled in 2000, then 2000 is year one for him, and 2001 is year two. “Since the MEPS survey questions we employed in our study analyses didn’t change from year to year during the 2000–2008 period, we were able to pool data for waves of participants during these years — which dramatically increased the sample size (as opposed to just focusing on one wave) and statistical power to examine our study questions. Such pooling for analyses is common when using data from large surveys like MEPS, when the data collection approach remains the same over a period of years.”