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Do chest physicians follow-up too many patients?
A G Leitch1, S Parker, A Currie
1Royal Victoria Dispensary for Diseases of the Chest, Edinburgh, U.K.
Respiratory Medicine
|July 1, 1989
Summary
Many chest clinic patients attend too frequently. Study findings suggest that 20-70% of regular attenders could be safely discharged to general practitioner care, improving resource allocation.
Area of Science:
- Pulmonology
- Healthcare Management
- General Practice
Background:
- Regular attenders at chest outpatient clinics often have long-term follow-up schedules.
- Assessing the appropriateness of follow-up frequency and discharge is crucial for efficient healthcare delivery.
Purpose of the Study:
- To evaluate patient and physician perspectives on follow-up frequency in a chest clinic.
- To determine the potential for safely discharging patients to general practitioner (GP) care.
Main Methods:
- Surveyed 750 regular chest clinic attenders regarding follow-up frequency and discharge views.
- Collected opinions from clinic doctors and patients' GPs on follow-up appropriateness and discharge recommendations.
- Analyzed discrepancies between patient, clinic doctor, and GP assessments.
Main Results:
- Patients were most frequently seen every three months.
- Clinic doctors recommended discharge for 28% of patients; GPs recommended discharge for 21%.
- 69% of patients believed their condition would remain stable or improve under GP care, suggesting up to 70% could be safely discharged.
Conclusions:
- A significant proportion of chest clinic attenders may be managed safely in primary care.
- Discharging suitable patients could optimize specialist resource utilization and improve patient flow.
- Patient-reported outcomes suggest a high level of confidence in general practitioner care post-discharge.