title: Cost implications of human and automated follow-up in ambulatory care.
abstract: OBJECTIVE
  To compare the costs of human and automated follow-up processes in ambulatory care.
  
  
  METHODS
  Analysis of costs of nurse-initiated and interactive voice response (IVR) system follow-up interventions.
  
  
  METHODS
  Using national cost data and data on follow-up processes and outcomes from a previous study, we examined the costs to the healthcare system and providers of developing a follow-up process using nurse-initiated telephone calls compared with calls made by an IVR.
  
  
  RESULTS
  Whether using nurse-initiated telephone calls or IVR calls, costs over the first 2 years of follow-up for a practice assumed to have 4800 acute care patient visits per year are approximately the same. After 2 years, IVR follow-up is approximately $9000 per year less expensive than nurse follow-up. In addition, overall cost savings are greater with IVR.
  
  
  CONCLUSIONS
  Follow-up of ambulatory care patients is a way to assess risks of future problems and associated costs and to improve quality of care. An automated follow-up process using IVR is more efficient than one based on nurse-initiated follow-up calls.
authors: Center for Health Informatics for Patient Safety/Quality, Dept of Health Services Administration, University of Alabama at Birmingham, 1705 University Blvd, SHPB 590J, Birmingham, AL 35294. E-mail: eberner@uab.edu.
authors: Eta S
authors: ES
authors: Berner
authors: Jeffrey H
authors: JH
authors: Burkhardt
authors: Anantachai
authors: A
authors: Panjamapirom
authors: Midge N
authors: MN
authors: Ray
mesh_terms: D000553:Ambulatory Care / Q000191:economics*; D003199:Computer Systems; D003266:Continuity of Patient Care / Q000191:economics / Q000458:organization & administration*; D003365:Costs and Cost Analysis; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D013689:Telephone