Optimizing revisit intervals: reducing variability to enhance health care efficiency

Physicians often rely on follow-up appointments to help patients achieve their health care goals. This is particularly true of primary care, where physicians rely on longitudinal care practices to manage chronic illnesses such as diabetes and hypertension. However, although patients are often scheduled to return for a follow-up visit in 3 to 6 months, there is little evidence supporting these recommendations. In other words, revisit interval (RVI) assignment is often left exclusively to the provider's discretion. The lack of standards means RVIs may vary from physician to physician, impacted by subjective factors such as provider sex, geographical location, clinical heuristics, and administrative practice patterns. This inconsistency has serious implications. Scheduling revisits too frequently may result in resource overuse and increased administrative burden. Conversely, waiting too long before revisits may result in discontinuity of treatment, decreased physician-patient rapport, and, subsequently, suboptimal patient outcomes. The first and foremost step in ameliorating this issue involves investigating the relationship among RVIs, patient outcomes, and cost of care. Collecting data on the most efficacious RVIs for patients with varying disease states and severities will allow the development of evidence-based guidelines for RVI assignment. The garnered information could then be used to establish an algorithm capable of recommending optimal RVI based solely on patient characteristics. By eliminating variability in RVI assignment, unnecessary health care costs associated with resource overuse could be reduced and patient health outcomes enhanced.