BRIEF REPORT: Factors affecting outpatient follow-up compliance of emergency department patients

J Gen Intern Med. 2005 Oct;20(10):938-42. doi: 10.1111/j.1525-1497.2005.0216_1.x.


Background: Emergency department (ED) patients often fail to follow-up with referrals to outpatient clinics and physicians.

Objective: To compare the effects of 2 ED discharge instructional methods on outpatient follow-up compliance and to evaluate sociodemographic characteristics as possible factors affecting outpatient follow-up compliance.

Design and participants: Randomized trial of ED patients. At discharge, the intervention group had their follow-up appointment made and the standard group was given our hospital's referral service phone number to make their own follow-up appointment.

Measurements: Outpatient clinics were called 1 month after each subject's ED discharge to ascertain if they followed-up. Poisson regression was used to examine the effects of sociodemographic factors on follow-up compliance.

Results: Of 287 eligible subjects, 250 (87%) agreed to participate. Follow-up rates were 59% for the intervention group and 37% for the standard group (P<.001). Having a primary care physicians appeared to increase ED patients' outpatient follow-up compliance and having Medicaid insurance appeared to decrease outpatient follow-up compliance, but neither of these findings was statistically significant.

Conclusions: In our ED, patients who have their outpatient follow-up appointment made at discharge have a significantly greater probability of follow-up compliance compared with patients given standard discharge instructions. Most sociodemographic characteristics do not affect our ED patients' follow-up compliance.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Emergencies
  • Emergency Service, Hospital / standards*
  • Follow-Up Studies
  • Humans
  • Patient Compliance*
  • Patient Discharge
  • Patient Education as Topic* / methods
  • Patient Education as Topic* / standards
  • Treatment Outcome