Twenty-one studies (reported as 28 articles that described 24 studies) were included in the review: one randomised controlled trial (RCT), three controlled before-and-after studies, three cross-sectional studies and 14 uncontrolled before-after studies. The studies involved 1,536 practices (range one to 862). Overall, studies were at high risk of bias. Follow-up ranged from three months to approximately four years.
Wait time for an appointment: (eight studies)
Time to third-next available appointment was reduced with advanced access implementation; five studies that performed statistical analyses reported statistically significant reductions, with a mean time to third-next available appointment of less than five days.
Physician and practice outcomes: (14 studies)
Advanced access implementation significantly reduced no-show rate (11 studies); absolute change ranged from -24% to zero. Four (reported as five) of 11 studies reported statistically significant reductions, with greatest benefit among practices with high no-show rates at baseline. Other findings were reported in the review.
Patient satisfaction: (eight studies)
One of five studies reported a statistically significant improvement in overall patient satisfaction. None of the four studies that assessed patient satisfaction with the appointment system reported statistically significant improvements and one reported a worsening in patient satisfaction.
Evidence on continuity of care and clinical outcomes was limited and results were mixed.
Linear regression indicated a positive but non-significant relationship between time to third-next available appointment and no-show rate (five studies).