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Post-hospitalization followup appointment-keeping among the medically indigent
1Division of Preventive Medicine, University of Alabama at Birmingham 35205-4785.
Journal of Community Health
|October 1, 1993
Summary
Appointment-keeping for discharged patients was 60%. Factors like no copayment, single appointments, apartment living, and non-primary care clinics improved compliance in this general medicine study.
Area of Science:
- Health Services Research
- General Medicine
- Public Health
Background:
- Follow-up appointment adherence is crucial for continuity of care after hospital discharge.
- Understanding factors influencing appointment-keeping is vital, especially in underserved populations.
Purpose of the Study:
- To measure follow-up appointment-keeping rates in patients discharged from a General Medicine Inpatient Service.
- To identify predictors of compliance with initial follow-up appointments.
Main Methods:
- Prospective study involving patient interviews at admission and chart reviews at discharge.
- Telephone interviews conducted one month post-discharge for a subset of patients.
- Analysis of 195 patients discharged alive from an urban public teaching hospital.
Main Results:
- A 60% compliance rate (95% CI: 53% to 67%) was observed for the first follow-up appointment.
- Key predictors of compliance included: no copayment (OR 3.2), single appointment (OR 2.9), apartment dwelling (OR 3.2), and non-primary care clinic (OR 2.3).
- Seventy-five percent of patients lacked medical insurance.
Conclusions:
- Healthcare delivery factors, particularly the absence of copayment requirements, significantly influence appointment-keeping in public hospital populations.
- Interventions addressing financial barriers and appointment scheduling may improve follow-up care adherence.