Davis Scott A, Lin Hsien-Chang, Yu Cheng-Han, Balkrishnan Rajesh, Feldman Steven R
J Drugs Dermatol. 2014 Jul;13(7):833-6.
Early follow-up visits improve patient adherence, but the actual scheduling behavior of physicians is not known.
To characterize the timing of first follow-up visits in US dermatologic practice.
Patients with a diagnosis of psoriasis, acne, or atopic dermatitis were identified in the 2003-2007 MarketScan Medicaid database. Factors affecting the length of time before first follow-up were assessed using a Cox proportional hazards model.
Mean length of time to the first follow-up visit was 153 days for adults and 142 days for children with psoriasis; 151 days for adults and 218 days for children with acne; and 161 days for adults and 209 days for children with atopic dermatitis. Black and those other than white patients were less likely than whites to receive early follow-up in psoriasis and acne, but more likely in atopic dermatitis. Dermatologists were more likely to schedule early follow-up visits than nondermatologists.
The database includes only Medicaid patients. The rate of non-attendance at scheduled visits could not be determined.
Most physicians are missing the opportunity to maximize patient adherence by scheduling early follow-up visits. Contact by email or phone may be beneficial for physicians who cannot schedule early follow-up.
早期随访有助于提高患者的依从性，但医生实际的预约安排行为尚不清楚。
描述美国皮肤科实践中首次随访的时间安排。
在2003 - 2007年市场扫描医疗补助数据库中识别出诊断为银屑病、痤疮或特应性皮炎的患者。使用Cox比例风险模型评估影响首次随访前时间长度的因素。
银屑病成年患者首次随访的平均时间为153天，儿童为142天；痤疮成年患者为151天，儿童为218天；特应性皮炎成年患者为161天，儿童为209天。在银屑病和痤疮患者中，黑人及非白人患者比白人患者接受早期随访的可能性更小，但在特应性皮炎患者中情况则相反。皮肤科医生比非皮肤科医生更有可能安排早期随访。
该数据库仅包含医疗补助患者。无法确定预约就诊的未到诊率。
大多数医生因未安排早期随访而错失了最大化患者依从性的机会。对于无法安排早期随访的医生而言，通过电子邮件或电话联系可能会有所帮助。
