Follow-up: who needs it?

The ability of pediatric residents to appropriately assign patients to receive follow-up has not previously been studied. We independently reviewed 1693 consecutive charts of patients presenting to the pediatric emergency department. The authors agreed with 60 of the 82 resident-assigned follow-ups and identified 99 patients who should have been assigned to receive follow-up but were not (missed follow-ups). When compared with the group appropriately assigned to receive follow-up care, the missed follow-up group was similar in sex, type of insurance, and time of presentation but tended to be younger and was significantly different in terms of mean temperature and health care provider. In regard to the latter, the missed follow-up group had a lower mean temperature and more often had an identifiable routine health care provider. Young age and respiratory difficulty were the factors contributing most to the authors' assignment as a missed follow-up. Specific formal teaching directed at the appropriate use of follow-up for outpatients should be incorporated into pediatric residency training curricula.