%0 Journal Article
%T Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States.
%A Corbisiero MF
%A Muffly TM
%A Gottman DC
%A Olson M
%A Hachicha Y
%A Garcia-Creighton E
%A Gallego N
%A Elsayed M
%A Ahmed S
%A Cabrera-Muffly C
%J Otolaryngol Head Neck Surg
%V 171
%N 1
%D 2024 Jul 12
%M 38606652
%F 5.591
%R 10.1002/ohn.752
%X <B>OBJECTIVE: </B>To investigate potential differences in new patient appointment wait times for otolaryngology care based on insurance types and explore factors influencing these wait times.<BR><B>METHODS: </B>A cross-sectional audit study, using a "mystery caller" approach, analyzed with a linear mixed Poisson model to adjust for confounding factors.<BR><B>METHODS: </B>A total of 612 physicians across 49 states and the District of Columbia, representing 6 otolaryngology subspecialties, were included.<BR><B>METHODS: </B>Otolaryngology physicians were contacted by mystery callers via telephone with scripted clinical vignettes as patients with either Medicaid or Blue Cross/Blue Shield (BCBS) insurance. Callers requested next available appointment. Wait times for new patient appointments were recorded and analyzed in R using a generalized linear mixed Poisson model.<BR><B>RESULTS: </B>A total of 1183 of 1224 calls reached a representative. Medicaid patients waited 5.73% longer (P < .001) compared to BCBS patients (IRR: 1.06; confidence interval [CI]: 1.03-1.09; P < .001), with respective mean wait times of 36.8 days (SE ± 1.6) and 32.4 days (SE ± 1.6). Longer waiting times were also associated with physicians affiliated with universities (P = .001) and certain subspecialties, such as pediatric otolaryngology (P < .001) and neurotology (P = .008). Regional differences were also observed, with specific AAO-HNS regions showing shorter wait times. The model achieved a conditional R-squared value of 0.947.<BR><B>CONCLUSIONS: </B>This study reveals disparities in wait times for otolaryngology care based on insurance type, with extended wait times for Medicaid beneficiaries. The findings highlight a potential access to care disparity, which begets the need for strategies that ensure equitable access to otolaryngology care and further research to understand the underlying reasons for these potential disparities.