Fosarelli P, DeAngelis C, Kaszuba A
Department of General Pediatrics, Johns Hopkins Medical Institution, Baltimore, MD 21205.
Am J Prev Med. 1985 May-Jun;1(3):23-9.
We studied all follow-up visits generated by initial emergency room (ER) visits made over the course of one year by patients enrolled in a pediatric primary care clinic (PCC). A total of 2,552 ER visits were made by 714 patients, 960 (37.6 percent) of these resulting in a follow-up visit. Of the 960, (82.4 percent) resulted in appointments to the PCC, with a 53.9 percent compliance rate; and 169 (17.6 percent) resulted in appointments to the ER, with an 89.3 percent compliance rate (p less than .001). Factors found to be associated with greater compliance with follow-up appointments were (1) the appointment being made to the ER rather than to the clinic, (2) the child being less than 18 months of age, (3) the patient having private insurance, and (4) an initial ER diagnosis of trauma, seizure, or burn. Factors found to be unrelated to compliance with follow-up visits were the patient's sex (when corrected for trauma cases), race, having a chronic condition, having a telephone, length of time as a clinic enrollee, distance from home to hospital, and type of primary provider (physician versus nurse practitioner).
我们研究了一家儿科初级保健诊所（PCC）的患者在一年时间内由最初的急诊室（ER）就诊产生的所有后续就诊情况。714名患者共进行了2552次急诊室就诊，其中960次（37.6%）产生了后续就诊。在这960次后续就诊中，（82.4%）是预约到初级保健诊所，依从率为53.9%；169次（17.6%）是预约到急诊室，依从率为89.3%（p小于0.001）。发现与更高的后续预约依从性相关的因素有：（1）预约到急诊室而非诊所；（2）孩子年龄小于18个月；（3）患者有私人保险；（4）急诊室的初始诊断为创伤、癫痫或烧伤。发现与后续就诊依从性无关的因素有患者的性别（校正创伤病例后）、种族、患有慢性病、有电话、作为诊所登记患者的时间长度、家到医院的距离以及初级医疗服务提供者的类型（医生与执业护士）。
