How Long Does It Take to See a Neurologist?

The average wait time to see a neurologist following an initial referral was just over a month for older adults, with nearly 1 in 5 patients waiting more than 3 months, a cross-sectional analysis of Medicare data showed.

Wait times were not affected by the number of available neurologists. However, those with multiple sclerosis (MS), epilepsy, Parkinson’s disease (PD), dementia, and sleep disorders had the longest wait times.

“In general, early referral to specialists has been shown to improve outcomes and increase patient satisfaction,” said study author Chun Chieh Lin, PhD, MBA, of The Ohio State University in Columbus, Ohio, in a press release. “Our findings underscore the need to develop new strategies to help people with neurological conditions see neurologists faster.”

The findings were published online on January 8 in Neurology.

No National Benchmark for Wait Times

For this study, researchers analyzed a large sample of fee-for-service Medicare data from 2src18 to 2src19. Researchers identified patients with a year or less between their last referring physician visit and a new neurologist visit.

Exclusion criteria included enrollment in health maintenance organization plans without continuous enrollment in Medicare Part A and Part B for 2 years before the index neurologist visit, missing patient data, no physician referral at all, or referral by a different neurologist.

In addition to assessing wait times, investigators examined the availability of neurologists who provided medical services to Medicare beneficiaries in the 2src18 dataset across 3src6 hospital referral regions in the United States, based on zip codes.

Results showed that 163,313 patients (average age, 74 years; 58% women; 85% White) were referred by 84,975 physicians to 1src,25src neurologists across the United States.

Overall, the average wait time from physician referral to index neurologist visit was 34 days (range, 1-365 days), with longer wait times for White patients, women, and those aged 65-69 years. Overall, 18% waited longer than 9src days for an appointment.

The most common conditions diagnosed at the index neurologist visit were chronic pain/abnormality of gait (13%), sleep disorders (11%), and peripheral neuropathy (1src%).

Using a linear mixed-effects statistical model, investigators found that patients with back pain waited an average of 3src days to see a neurologist, with longer waits for other conditions. Those with MS had an average wait that was 29 days longer, patients with epilepsy waited an average of 1src days longer, and those with PD waited 9 days longer (P <.srcsrcsrc1).

The number of available neurologists (range, 1src-5src neurologists per 1srcsrc,srcsrcsrc Medicare patients) did not affect wait times. However, there were differences in wait times across states due to different policies or regulations regarding healthcare access, with wait times ranging from a median high of 49 days in Idaho to a low of 24 days in Wyoming.

Notably, when patients saw a neurologist outside of their physician’s referral area, wait times were longer by an average of 11 days.

More than 4src% of patients with new neurology referrals had prior office-based visits for the same neurologic diagnosis. For these patients, the median time between diagnosis and index neurologist visit was 342 days (range, 66-753 days).

Female patients in this category waited slightly longer (median, 353 days) than male patients (median, 328 days), and Black and Hispanic patients had longer median waits than White patients (389.5 days and 397 days respectively, vs 337 days; P=.srcsrcsrc3).

“It is important to note that there is no national benchmark for determining appropriate wait times for specialist care, making it difficult to standardize expectations for timely access to specialists,” the authors noted.

The investigators suggested that a direct communication channel between primary care physicians and neurologists such as an eConsult service may hasten access to neurology consultation without the need for a formal appointment. Telemedicine in rural areas could also shorten wait times, they added.

Study limitations included the inability to determine if patients followed through with their index neurology visits or whether the last visit with the physician was the time of referral, as this could