title: How well do patients obtain short-term follow-up after discharge from the emergency department?
abstract: OBJECTIVE
  We sought to determine the follow-up rate of discharged emergency department patients who were instructed to obtain reevaluation within 48 hours at our ED, a clinic, or a private physician's office and to determine the reasons why patients do not obtain short-term follow-up when instructed.
  
  
  METHODS
  Emergency physicians prospectively enrolled a convenience sample of patients discharged from a university hospital ED who were believed to be at risk for clinical deterioration. Patients were instructed to obtain reevaluation within 48 hours at a public clinic, private physician's office, or our ED (without charge). A telephone interview was conducted after 48 hours had elapsed.
  
  
  RESULTS
  Three hundred twenty-five patients were enrolled, 300 were included in data analysis, and 203 (67.7%) of these obtained follow-up as instructed. Those referred to the ED had a higher follow-up rate (105/127 [82.7%]) than those referred to clinics (59/99 [59.6%]) or private physicians (39/74 [52.7%]). Inability to obtain an appointment was cited by 34.3% of those who did not obtain follow-up care as instructed.
  
  
  CONCLUSIONS
  Many patients discharged from the ED who were believed to be at risk for clinical deterioration did not obtain medical follow-up within 48 hours when so instructed. Free ED follow-up resulted in a better rate of short-term follow-up than that for clinics and private physicians and may be especially useful if a patient's ability to obtain follow-up is uncertain or if timely reevaluation is particularly imperative.
authors.affiliation: State University of New York University Medical Center at Stony Brook, Department of Emergency Medicine, Stony Brook, NY, USA. dbarlas@nshs.edu
authors.forename: D
authors.initials: D
authors.lastname: Barlas
authors.forename: C S
authors.initials: CS
authors.lastname: Homan
authors.forename: J
authors.initials: J
authors.lastname: Rakowski
authors.forename: M
authors.initials: M
authors.lastname: Houck
authors.forename: H C
authors.initials: HC
authors.lastname: Thode
mesh_terms: D003153:Community Health Services; D003266:Continuity of Patient Care; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010351:Patient Discharge; D011331:Private Practice; D011446:Prospective Studies; D016312:Treatment Refusal; D014481:United States