From the MetroHealth System, Cleveland, OH.
J Am Acad Orthop Surg. 2020 Sep 15;28(18):e815-e822. doi: 10.5435/JAAOS-D-19-00132.
Attending clinic appointments after injury is crucial for orthopaedic trauma patients to evaluate healing and to update recommendations. However, attendance at these appointments is inconsistent. The purpose of this study was to assess the effect of a personalized phone call placed 3 to 5 days after hospital discharge on attendance at the first postdischarge outpatient clinic visit.
This prospective study was done at an urban level 1 trauma center. One hundred fifty-nine patients were exposed to a reminder phone call, with 33% of patients being reached for a conversation and 28% receiving a voicemail reminder. Phone calls were made by a trained trauma recovery coach, and the main outcome measure was attendance at the first postdischarge clinic visit.
Eighty-six patients (54%) attended their scheduled appointments. Appointment adherence was more common among the group reached for a conversation (70% versus 51% for voicemail cohort and 34% for no contact group). Patients exposed to the Trauma Recovery Services (TRS) during their hospital stay attended appointments more often (91% versus 61%, P = 0.026). Age, sex, mechanism of injury, and distance from the hospital were not associated with specific follow-up appointment adherence. Insured status was associated with higher attendance rates (71% versus 46%, P = 0.0036). Other economic factors such as employment were also indicative of attendance (64% versus 48%, P = 0.05). Current tobacco use was associated with poor appointment attendance (30%) versus 56% for nonsmokers (P = 0.001).
Patients reached by telephone after discharge had better rates of subsequent clinic attendance. Economic factors and substance use appear vital to postoperative clinic visit compliance. Patients with met psychosocial needs, as identified by individuals with satisfactory emotional support, and exposure to TRS had the highest rates of postdischarge appointment attendance.
对于骨科创伤患者来说，在受伤后就诊以评估愈合情况并更新建议至关重要。然而，他们的就诊率并不一致。本研究的目的是评估在出院后 3 至 5 天内拨打个性化电话对首次出院后门诊就诊的影响。
这是一项在城市一级创伤中心进行的前瞻性研究。共有 159 名患者接受了提醒电话，其中 33%的患者进行了电话交谈，28%的患者收到了语音邮件提醒。电话由经过培训的创伤康复教练拨打，主要结局指标是首次出院后门诊就诊的就诊率。
86 名（54%）患者按时就诊。与语音邮件组（51%）和无联系组（34%）相比，进行了电话交谈的患者就诊率更高（70%）。在住院期间接受创伤康复服务（TRS）的患者就诊率更高（91% vs. 61%，P = 0.026）。年龄、性别、受伤机制和与医院的距离与特定随访就诊率无关。保险状况与更高的就诊率相关（71% vs. 46%，P = 0.0036）。其他经济因素，如就业情况，也与就诊率相关（64% vs. 48%，P = 0.05）。目前吸烟与较差的就诊率相关（30% vs. 56%，非吸烟者，P = 0.001）。
出院后通过电话联系的患者随后就诊率更高。经济因素和物质使用似乎对术后门诊就诊的依从性至关重要。有精神社会需求的患者，如得到满意情感支持的人所识别的，以及接受 TRS 的患者，其出院后预约就诊率最高。
