Background: An Institute of Medicine (IOM) report defines six domains of quality of care: safety, patient-centeredness, timeliness, efficiency, effectiveness, and equity. The effect of emergency department (ED) crowding on these domains of quality has not been comprehensively evaluated.
Background: Emergency department (ED) patients often fail to follow‐up with referrals to outpatient clinics and physicians.
Objective: To compare the effects of 2 ED discharge instructional methods on outpatient follow‐up compliance and to evaluate sociodemographic characteristics as possible factors affecting outpatient follow‐up compliance.
Design and Participants: Randomized trial of ED patients. At discharge, the intervention group had their follow‐up appointment made and the standard group was given our hospital's referral service phone number to make their own follow‐up appointment.
Measurements: Outpatient clinics were called 1 month after each subject's ED discharge to ascertain if they followed‐up. Poisson regression was used to examine the effects of sociodemographic factors on follow‐up compliance.
RESULTS: Of 287 eligible subjects, 250 (87%) agreed to participate. Follow‐up rates were 59% for the intervention group and 37% for the standard group (P<.001). Having a primary care physicians appeared to increase ED patients' outpatient follow‐up compliance and having Medicaid insurance appeared to decrease outpatient follow‐up compliance, but neither of these findings was statistically significant.
Conclusions: In our ED, patients who have their outpatient follow‐up appointment made at discharge have a significantly greater probability of follow‐up compliance compared with patients given standard discharge instructions. Most sociodemographic characteristics do not affect our ED patients' follow‐up compliance.
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