• Kevin N Griffith, Donglin Li, Michael L Davies, Steven D Pizer, and Julia C Prentice.
• VA Boston Healthcare System, 150 S Huntington Ave, Jamaica Plain Campus, Bldg 9, Boston, MA 02122. Email: kevin.griffith@va.gov.
• Am J Manag Care. 2019 Sep 1; 25 (9): e282e287e282-e287.

ObjectivesThere is little research on the relationship between call center performance and patient-centered outcomes. In this study, we quantified the relationships between 2 measures of telephone access, average speed of answer (ASA) and abandonment rate (AR), and patient satisfaction outcomes within the Veterans Health Administration (VHA).Study DesignWe analyzed 2015 and 2016 data from the Survey of Healthcare Experiences of Patients and linked them with administrative data to gather features of the patient visit and monthly measures of telephone access for each medical center.MethodsWe used mixed effects logistic regression models to estimate the effects of ASA and AR on a variety of access and satisfaction outcomes. Models were adjusted for patient-level demographics, time-varying facility-level characteristics, features of the patient visit, and facility-level random effects to control for care quality and case mix differences.ResultsThe VHA made substantial strides in both access measures between 2015 and 2016. We found that a center's ASA was inversely associated with patients' perceptions of their ability both to access urgent care appointments and to do so in a timely manner. In contrast, telephone AR was not associated with any of the patient satisfaction outcomes.ConclusionsOur results associate decreased telephone waits with improved perceptions of urgent care access even without concomitant decreases in observed appointment waits. These findings may have important implications for regulators as well as for healthcare organizations that must decide resource levels for call centers, including hospitals, federal health insurance exchanges, and insurers.

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