Findings from University of Colorado School of Medicine in the Area of Managed Care Reported (Assessment of Gynecologic Emergency Triage and Appointment Wait Times: A Mystery Caller Study): Managed Care

2025 NOV 05 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Managed Care is the subject of a report. According to news reporting originating in Aurora, United States, by NewsRx journalists, research stated, “Front desk staff are often responsible for triaging patients, despite lacking formal medical training. Incorrect triage recommendations could result in patients delaying care for emergent conditions.”

The news reporters obtained a quote from the research from the University of Colorado School of Medicine, “No research exists to characterize triage accuracy in the gynecologic outpatient setting. We investigated the ability of clinician office staff to identify emergent conditions and advise patients accordingly. Additionally, we sought to understand the influence of private versus public insurance on appointment wait time and triage recommendations. Obstetrician-gynecologist (OB/GYN) office phone numbers were identified from the Centers for Medicare and Medicaid Services National Practice and Provider Enumeration System and contacted using a covert mystery caller study approach. Half of the calls described a gynecologic emergency that required immediate intervention, while the other half described a gynecologic condition that required urgent evaluation. In the ‘Emergent’ scenarios, callers described a positive pregnancy test after tubal ligation or a tubo-ovarian abscess. In the ‘Urgent’ scenarios, callers described a urinary tract infection or recurrent vaginitis. The date of the soonest appointment and triage recommendations were recorded. Our sample included 1,114 calls to 557 unique physician offices from 48 states (excluding North Dakota and Rhode Island). Of the physician offices contacted, 371 physicians met the inclusion criteria. In this sample, 75.2% of OB/GYN offices accepted Medicaid. The median physician age was 53 (IQR 44-61), and almost two-thirds (63.2%) of physicians contacted were female. A total of 142 callers were instructed to seek emergency care, transferred to a nurse triage line, or offered provider consultation. Of Emergent scenario callers, 21.5% (n = 60/N = 279) were correctly triaged. Eighty-two of the 279 Urgent scenario callers (29.4%) were incorrectly instructed to seek emergency care. There was no significant difference in appointment wait time or triage recommendation based on insurance. Calls to female physicians were associated with shorter wait times (p < 0.01), while academic physicians (p < 0.01) and longer call hold times (p = 0.04) were associated with longer wait times. Wait times varied significantly between clinical scenarios. To the best of our knowledge, this is the first nationwide audit of OB/GYN office staff patient triage. Our results revealed that patients are often incorrectly triaged and offered future appointments for emergency conditions that require immediate attention. Faulty triage results in significantly delayed treatment, which can impede patients’ future fertility or threaten their lives.”

According to the news reporters, the research concluded: “We propose the development of a standardized resource to increase telephone triage accuracy and minimize patient harm.”

This research has been peer-reviewed.

For more information on this research see: Assessment of Gynecologic Emergency Triage and Appointment Wait Times: A Mystery Caller Study. Cureus, 2025;17(9).

Our news correspondents report that additional information may be obtained by contacting Brisa Avila, Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, United States. Additional authors for this research include Melanie G. Mandell, Kori A. Baker, Kimberly Christnacht, Rebekah Coelho, Tamara Corley, Douglas Fritz, Kristina E. Johnson, Neya Manavalan, Madeleine M. Mason, Payton Moody and Tyler Muffly.

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