Medicaid Patients Experience Longer Wait Times at Academic Urology Clinics Compared to Patients with Medicare

Introduction: It has been established that Medicaid patients face unequal access to health care. There is a paucity of literature comparing wait times for Medicaid patients to those of patients with other types of insurance. We determined whether Medicaid patients experience longer wait times at academic urology clinics compared to patients with Medicare. Methods: A prospective cross-sectional telephone survey was conducted in October 2016. The study involved collection of data from multiple academic centers with telephone interviews conducted from a single institution. Calls were made to all accredited urology residency programs (131). Earliest appointment times were established for fictional patients with Medicaid and then Medicare. The main outcome was the difference in wait times for a new patient appointment in a urology clinic for Medicaid vs Medicare patients. The wait time in days was the difference between the date of the appointment and the date of the telephone call. Results: There were 108 academic urology clinics that accepted Medicaid and Medicare patients in our final analysis (82.4% participation rate). A 2-tailed t-test was performed with unequal variances for the wait times between Medicaid and Medicare groups. There was a significant difference (p <0.001) between mean wait times for a patient with Medicare (23 days, SD 20.8; 95% CI 19.0, 26.9) vs Medicaid (35 days, SD 27.5; 95% CI 30.0, 40.3). Conclusions: Our data suggest that Medicaid patients experience longer wait times for their initial outpatient urological evaluation. These findings may be used for future health policy considerations.