Samade Richard, Colvell Kara, Goyal Kanu S
The Ohio State University Wexner Medical Center, Columbus, USA.
Hand (N Y). 2021 Jan;16(1):104-109. doi: 10.1177/1558944719840743. Epub 2019 Apr 4.
Incomplete patient follow-up is a common problem after hand and upper extremity (HUE) surgery and is influenced by many demographic factors. The aims of this investigation are to determine patient-stated factors for lack of follow-up, identify potential interventions, and measure satisfaction following operations. A prospective survey sampling of 173 of 655 patients lost to follow-up after HUE operations in a single institution between June 2014 and July 2015 was performed. Demographic variables collected included age, sex, distance to clinic, insurance payor, and length of time to last follow-up visit. Survey responses regarding reasons for insufficient follow-up, future recommendations, and overall satisfaction were recorded. Statistical results were reported as values, odds ratios (ORs), and 95% confidence intervals (CIs). More than half (65.3%) of 173 patients erroneously thought that they had completed follow-up, with private insurance being the only risk factor (OR = 2.45, = .010, 95% CI = 1.24-4.85). Other common reasons for insufficient follow-up included not placing the appointment into a personal calendar (7%), excessive costs (6%), and transportation (5%). Approximately half (51%) of 55 patients aware that they had missed follow-up stated that no intervention would have helped. Median patient satisfaction with their operation was 10/10 (interquartile range = 8-10). Most patients lost to follow-up after HUE operations were not aware that they had a follow-up appointment, but were nevertheless satisfied with treatment. Interventions targeted to patients who erroneously thought they had followed up may be the most beneficial.
手部及上肢手术（HUE）后患者随访不完整是一个常见问题，且受多种人口统计学因素影响。本研究的目的是确定患者自述的未进行随访的因素，识别潜在干预措施，并衡量术后满意度。对2014年6月至2015年7月间在单一机构接受HUE手术后失访的655例患者中的173例进行了前瞻性调查抽样。收集的人口统计学变量包括年龄、性别、到诊所的距离、保险支付方以及上次随访就诊的时间长度。记录了关于随访不足原因、未来建议和总体满意度的调查回复。统计结果以P值、比值比（OR）和95%置信区间（CI）表示。173例患者中有超过一半（65.3%）错误地认为他们已经完成了随访，私人保险是唯一的风险因素（OR = 2.45，P = .010，95% CI = 1.24 - 4.85）。随访不足的其他常见原因包括未将预约安排进个人日程（7%）、费用过高（6%）和交通问题（5%）。在55例意识到自己错过随访的患者中，约一半（51%）表示没有干预措施会有帮助。患者对手术的满意度中位数为10/10（四分位间距 = 8 - 10）。大多数HUE手术后失访的患者不知道他们有随访预约，但仍对治疗感到满意。针对错误地认为自己已经进行了随访的患者的干预措施可能是最有益的。
