Availability of Outpatient Care From Psychiatrists: A Simulated-Patient Study in Three U.S. Cities
Abstract
Objectives The study examined availability of psychiatrists for outpatient appointments in three U.S. cities. Methods Posing as patients, investigators called 360 psychiatrists listed in a major insurer's database in Boston, Houston, and Chicago (N=120 per city) and attempted to make appointments. Callers claimed to have Blue Cross Blue Shield or Medicare or said they would pay out of pocket (N=120 per payer type, divided evenly across cities). Results In round 1 of calling, investigators were able to reach 119 of the 360 psychiatrists (33%). Of 216 unanswered calls, 36% were returned. After two calling rounds, appointments were made with 93 psychiatrists (26%). Significant differences were noted between cities but not between payer type. Conclusions Obtaining outpatient appointments with psychiatrists in three cities was difficult, irrespective of payer. RESULTS suggest that expanding insurance coverage alone may do little to improve access to psychiatrists-or worse, expansion might further overwhelm the capacity of available services.
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Insurance-provided search portals regularly surface results utilizing out of date directories and recommend providers who are neither appropriate for the client's needs, available, nor taking new clients.
“Insurance-provided search portals, the most prevalent tool, regularly surface results utilizing out of date directories and recommend providers who are neither appropriate for the client’s needs, available, nor taking new clients.8-10”
From Using Machine Learning to Match Clients and Therapy Providers: Evaluating Clinical Quality and Cost of Care (2025) · cites this paper as [10]
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- Authors
- Malowney, M., Keltz, S., Fischer, D., & Boyd, J. W.
- Affiliations
- Cambridge Health Alliance (US)
- Venue
- Psychiatric Services
- Published
- 2015-01-01
- Volume
- 66
- Issue
- 1
- Pages
- 94-96
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2159810309
- Cited by
- 79
- References
- 7
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 6 · 2023: 8 · 2022: 14 · 2021: 9 · 2020: 11 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 6 · 2015: 2
- FWCI
- 6.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- access to mental health care, outpatient appointments, appointment scheduling, standardized patients, insurance coverage, Medicare, Blue Cross Blue Shield, health care access disparities, urban mental health services
- MeSH terms
- Ambulatory Care, Appointments and Schedules, Boston, Chicago, Health Services Accessibility, Humans, Psychiatry, Texas
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