title: Post-hospitalization followup appointment-keeping among the medically indigent.
abstract: The purpose of this study was to measure followup appointment-keeping in patients discharged from a General Medicine Inpatient Service and to identify possible predictors of compliance. Patients were interviewed on hospital admission and all charts were reviewed on discharge. A subset of patients were interviewed by telephone an average of one month after first followup appointment date. The study was conducted in an urban public teaching hospital with hospital-based and community clinics. A convenience sample of 209 patients were selected from admissions to the General Medicine Inpatient Service over a three month period. Followup appointment-keeping was recorded on all 195 patients discharged alive. Seventy-five percent of patients had no medical insurance, public or private. A compliance rate of 60% (95% confidence interval: 53% to 67%) with first followup appointment was found. Variables associated with compliance and which retained independence on multiple logistic regression analysis, followed by adjusted odds ratios (95% confidence intervals) were: no copayment requirement, odds ratio 3.2 (1.6 to 6.3), single followup appointment 2.9 (1.4 to 5.9), apartment dwelling 3.2 (1.4 to 7.3) and non-primary care clinic appointment 2.3 (1.1 to 4.8). We conclude that health-care-delivery related factors such as no copayment requirements are strongly associated with appointment-keeping in a public hospital population.
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham 35205-4785.
authors.forename: C I
authors.initials: CI
authors.lastname: Kiefe
authors.forename: P L
authors.initials: PL
authors.lastname: Harrison
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000191:economics / Q000706:statistics & numerical data*; D000368:Aged; D001071:Appointments and Schedules; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003669:Deductibles and Coinsurance; D005260:Female; D005500:Follow-Up Studies; D006746:Hospital Bed Capacity, 500 and over; D006779:Hospitals, Public / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008489:Medical Indigency / Q000706:statistics & numerical data*; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D010349:Patient Compliance; D013781:Texas