Follow-up compliance after emergency department evaluation

Ann Emerg Med. 1993 Mar;22(3):560-7. doi: 10.1016/s0196-0644(05)81942-0.


Study objective: To identify factors associated with outpatient follow-up of emergency department visits.

Design: A retrospective review of 587 ED charts meeting strict criteria was performed. The following variables were identified: method used to arrange follow-up, age, sex, consultant contacts, distance from patient's residence to hospital, previous physician, recommended time to clinic return, and funding source. Compliance was assessed using the outpatient registration computer data base.

Setting: ED and outpatient clinics of an urban university teaching hospital.

Participants: Inclusion criteria were age between 18 and 75 years, patient released to outpatient care, and instructions specifying a university hospital clinic or ED follow-up and a time period within which this appointment was to occur. Follow-up options included patients being asked to return to the ED on a specific day (group 1), being given a specific clinic appointment (group 2), or being given the clinic telephone number and instructed to call for an appointment (group 3).

Results: Compliance rates, defined as follow-up within seven days of the recommended date, were group 1, 51%; group 2, 65%; and group 3, 46%. Significant confounding factors adversely affecting follow-up as determined by multiple logistic regression analysis were decreasing age (P < .05), absence of insurance (P < .01), and no ED consultation with follow-up clinic physician (P < .01). Controlling for these factors and the reason for follow-up showed that having the patient schedule their own follow-up was associated with poor follow-up compliance (P < .001).

Conclusion: Compliance with follow-up is multifactorial. Consultant contact at the time of initial patient evaluation and provision of a return visit appointment at the time of ED release should improve compliance in a university hospital setting.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Appointments and Schedules
  • Confounding Factors, Epidemiologic
  • Data Interpretation, Statistical
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Insurance, Health
  • Male
  • Middle Aged
  • Oregon
  • Outpatient Clinics, Hospital / statistics & numerical data
  • Patient Compliance*
  • Referral and Consultation*
  • Retrospective Studies