Variation in Follow-Up Visit Practices Across Clinicians and Conditions: Findings From a University Cardiology Practice
Caterina Yuan Liu1, Ralph Gonzales2
1School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Insights
Specialty cardiology practices show significant variation in follow-up visit patterns among providers. Understanding these differences can help standardize care and reduce unnecessary follow-up visits for patients.
Area of Science:
- Cardiology
- Health Services Research
Background:
- Specialty care access is limited by rising demand.
- Follow-up visit patterns after initial consultation are understudied.
- Understanding these patterns is crucial for optimizing patient care pathways.
Purpose of the Study:
- To examine follow-up visit patterns for new patients in a university cardiology practice.
- To identify independent predictors of follow-up visits.
- To explore variations in practice patterns among providers.
Main Methods:
- Retrospective cohort study utilizing electronic medical record data.
- Analysis of new patient visits to a cardiology practice.
- Identification of follow-up visits as the primary outcome.
Main Results:
- Significant provider-to-provider variation in follow-up visit patterns was observed, even after controlling for patient and disease factors.
- A small subset of patients accounted for the majority of follow-up care.
- Practice patterns demonstrated considerable heterogeneity across providers.
Conclusions:
- Follow-up visits in specialty care present a key area for standardization and quality improvement initiatives.
- Further research is needed to fully understand the dynamics of follow-up visits in specialty cardiology.
- Analyzing provider-specific differences may reveal opportunities to minimize unnecessary follow-up appointments.
Background:
Specialty care access is increasingly constrained due to increasing demand for specialty care. Although much attention has been placed on the initial referral decision, much less is known about follow-up visit patterns. We examined the patterns of follow-up visits for new patients to a university-based cardiology practice and identified independent predictors of follow-up visits.
Methods:
This is a retrospective cohort study of new patient visits using electronic medical record data. The primary outcome was a follow-up visit.
Results:
Substantial variation in practice patterns by provider persisted after accounting for patient and disease factors. Most follow-up care was concentrated in a small population of patients.
Conclusion:
Specialty care follow-up visits may represent a significant opportunity for standardization and quality improvement, and further studies are warranted to understand follow-up visits in specialty care.
Implications:
Better understanding of between-provider differences could identify ways to reduce unnecessary follow-up visits.
Level Of Evidence:
Single-institution study.
Related Concept Videos
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:27Coronary Artery Disease V: Interprofessional Care
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:22Myocarditis IV: Nursing Management
01:18Endocarditis III: Medical Management