The emergency room and the hypertensive patient. Improving linkage to clinical care

The authors evaluated three methods of referring new hypertensive patients from a large municipal hospital emergency room to an ongoing medical care system. A total of 239 patients were assigned to one of three groups. Compliance with recommendations to receive follow-up care was compared for each group. Forty-two percent of patients who received a routine referral from nurses or physicians plus a follow-up telephone call or letter complied. Thirty percent of patients who received a referral from a specially trained interviewer to the hospital's outpatient assessment area complied. These two groups were not significantly different. Compliance was significantly greater (65%, P less than 0.001) for a third group of patients who received an appointment from an interviewer to the outpatient general medicine clinic. The appointment was within 3 days from the time of the emergency room visit. An early appointment intervention given to new high blood pressure patients in the emergency room is recommended to improve patient return for follow-up care, thereby improving linkage to an ongoing care system.