Telephone follow-up of patients discharged from the emergency department: how reliable?
As the result of the current emphasis on health care cost containment, outpatient management of entities previously in the domain of inpatient therapy is being proposed. The advocates of this approach stress the importance of telephone follow-up in patients chosen for outpatient therapy. Our objective was to determine the reliability of phone follow-up in patients discharged from the emergency department (ED). We attempted to contact by phone 250 consecutive children evaluated and discharged from Loyola University Medical Center Emergency Department. A maximum of six attempts per patient was made starting within 72 hours of the ED visit. Calls were placed to home, work, and contact numbers provided at the time of the ED visit, and messages were left on answering machines or with persons who answered the phone. The time needed to reach the guardian was calculated from the time of the first call until successful contact of the guardian. We were successful in contacting 68.4% of our study subjects. Patients with commercial insurance were contacted more often than those with other types of insurance. A mean of 1.61 +/- 1.09 calls were needed to reach the guardians who were successfully contacted, and the mean time required was 3.14 +/- 7.25 hours. Medical indication for telephone follow-up, as determined by the managing physician, did not influence our ability to reach the study subjects. In view of our moderate success rate in reaching patients discharged from the ED, we advocate caution in the implementation of outpatient strategies in the management of febrile children who are at high risk for life-threatening complications.
Horne
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Department of Pediatrics, Loyola University Medical Center, Maywood, IL 60153, USA.
Ros
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D000293:Adolescent; D000359:Aftercare / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards*; D005334:Fever / Q000628:therapy; D006801:Humans; D007087:Illinois; D007223:Infant; D007231:Infant, Newborn; D010351:Patient Discharge; D013689:Telephone; D013997:Time Factors