To examine wait times for new neurology office visits among commercially insured persons.

Timely access to ambulatory specialty care is associated with decreased emergency department (ED) use, hospitalizations, and mortality. The wait time for a neurologist visit and characteristics impacting these waits among the commercially insured is largely unknown.

We conducted a retrospective, repeated cross-sectional study using 2019-2023 data from the Merative^TM MarketScan ® Commercial Database of ~20 million annual US enrollees. The outcome was wait time in days for new neurologist visit following primary care or ED visit. Mean (SD) and median (IQR) wait times were reported by sex, race, neurological condition, insurance type, and geographic region. Wait times were modeled using generalized estimating equations, clustering within Metropolitan Statistical Areas (MSAs), and adjusted for demographic, insurance, clinical, and geographic variables.

The average wait time among 114,050 enrollees for a new neurology visit was 49.7 days (SD = 65.40). Estimated  wait times differed by sex, with males waiting one week longer than females (+7.0 days; 95% CI -7.8, -6.2), and by neurological condition, with shorter waits for stroke (-8.2 days; 95% CI -6.89, -9.52), dizziness or vertigo (-7.8 days; 95% CI -5.1, -10.4), and traumatic brain injury (-6.5 days; 95% CI -5.1 -8.0), and longer waits for multiple sclerosis (+4.0 days; 95% CI 6.07, 1.96). Visits in the Northeast Census region had the longest waits (+4.6 days; 95% CI 3.31, 5.97). Non-Hispanic white race (within MSA) was associated with reduced wait times (-0.18 days per percent white; 95% CI -0.22, -0.14). Enrollees in consumer driven health plans had the lowest wait times (-2.4 days, 95% CI -3.6, -1.2.) Neurologist density/100,000 enrollees was not associated with wait time (0.0 days: 95% CI -0.01, 0.00).

Wait times for new neurology appointments vary by sex, neurological condition, insurance type and geographic level variables.